Flexor Tendon Injuries

The performance of 50 consecutive digits in 37 patients was analyzed following flexor tendon repair in Zone II. Twenty-five digits were managed by 3 1/2 weeks of immobilization followed by a program of gradually increased motion; 25 other digits by intermittent passive motion initiated within the first 5 days with active flexion commenced at 4 1/2 weeks. Results were graded according to the percentage of return of motion at the proximal and distal interphalangeal joints. There were four ruptures in the immobilization group with no excellent results, 12% being rated good, 28% fair, and 11% poor. In the digits managed by early mobilization there were 36% excellent, 20% good, 16% fair, 24% poor; there was one rupture in this group. Early passive motion appeared to be an effective technique to improve the results of flexor tendon repairs in this area.

This article reviews recent reports of outcomes of flexor tendon repair and discusses the problems associated with such surgeries. Reports of no repair rupture in individual case series have emerged recently. Their results move toward the clinical goal of primary repair without repair rupture. The Strickland method remains the most common to record the outcomes. Outcomes should be provided by subzones of the tendon injuries, and the level of expertise of the surgeons expertise should be reported to allow comparisons of the results.

It generally is considered that a certain distance should be maintained between the site of the tendon-suture junction and the laceration level of the tendon. In this study we assessed how the length of core suture purchase may affect the repair strength of transversely cut tendons using a 2-strand modified Kessler method and a 4-strand circle-locking method.