Flexor tendon injuries in the child

Al‐Qattan, Mohammad M.

doi:10.1177/1753193413498207

Cited by 35 publications

(20 citation statements)

References 47 publications

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“…This study is limited depending on the number of included children and the result for both the late repair and suture technique may change if the number of children had been higher. Children are considered to have better ability to heal more rapidly and with less adhesions compared to adults [9,11], which is a reason to immobilize the hand and wrist after a flexor tendon injury in children and still achieve good result after mobilization. As with nerve injuries, the brain plasticity might also have an important role in the rehabilitation after a flexor tendon injury and explain to some extent the good results after flexor tendon repair in children [18].…”

Section: Discussionmentioning

confidence: 99%

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Early mobilization compared with immobilization after repair of a flexor tendon injury in children: A retrospective long time follow-up

Birkisson¹,

Dahlin²,

Rosberg³

2017

Hand Microsurg

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Objectives: To investigate if early mobilization and immobilization regimes influence long-term outcome after repair of a flexor tendon injury in fingers in children. Methods: A retrospective follow-up study (2003)(2004)(2005)(2006)(2007)(2008)(2009) was conducted in 27 children (1-16 years) with a flexor tendon injury, excluding a flexor tendon injury in the thumb. Early mobilization (n=17) or immobilization (n=10) was used. Range of motion (ROM; expressed in % of contralateral uninjured hand) in MCP, PIP, and DIP joints was measured, grip strength was recorded, and VAS for function and cosmetic was evaluated. Results: No ruptures or infections were observed. In the early mobilization group there were more boys; they had a higher age, more transection injuries, and more concomitant digital nerve injuries. However, no differences between the early mobilization and the immobilization groups for functional or cosmetic VAS, ROM for MCP, PIP, and DIP joints or for grip strength were found. Conclusions: The long-term outcome after a flexor tendon repair does not differ between early mobilization in older children and immobilization in younger children, implying that an early rehabilitation program is not necessary in young children.

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Section: Discussionmentioning

confidence: 99%

“…The treatment of choice in adults is surgery within 24 hours with a core suture, combined with running epitendinous sutures, and active rehabilitating starting 3-5 days postoperatively [9]. Whether 2-or 4-strand core sutures are being used depends on the size of the tendon and degree of injury.…”

Section: Introductionmentioning

confidence: 99%

Early mobilization compared with immobilization after repair of a flexor tendon injury in children: A retrospective long time follow-up

Birkisson¹,

Dahlin²,

Rosberg³

2017

Hand Microsurg

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“…Kinder sind mit einer Inzidenz von 3,6 pro 100 000 Einwohner pro Jahr selten betroffen. Hier handelt es sich in aller Regel um offene Beugesehnenverletzungen [3].…”

Section: Epidemiologieunclassified

Beugesehnenverletzungen

Büren¹,

Windolf²,

Lögters³

2017

Orthopädie und Unfallchirurgie up2date

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“… 3 , 4 The size of flexor tendons in children is smaller than adults, both in width and in thickness. 5 The application of 6-strand repairs is not easy in these small tendons due to the limited space available for the multi-strand core sutures. The use of 3/0 sutures (commonly used in adult repairs) is also not practical and one has to use 4/0 or 5/0 sutures depending on the age of the child and the size of the tendon.…”

mentioning

confidence: 99%

“…The use of 3/0 sutures (commonly used in adult repairs) is also not practical and one has to use 4/0 or 5/0 sutures depending on the age of the child and the size of the tendon. 5 Our literature review revealed one biomechanical study investigating the tensile strength of flexor tendon repairs in children less than 2 years of age (the width of flexor profundus tendon in this age group is 1-2 mm). 6 There are numerous studies investigating the tensile strength of flexor tendon repairs in adults (the width of flexor profundus tendon in adults is 6-7 mm).…”

mentioning

confidence: 99%

A biomechanical study of pediatric flexor profundus tendon repair

Al-Thunayan

Alzahrani

Hakeem

et al. 2016

SMJ

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Objectives:To investigate the tensile strength of repaired flexor profundus tendons in young lambs, which would be equivalent to repairs in children older than 2 years of age.Methods:A comparative in-vitro experimental study conducted at King Saud University, Riyadh, Kingdom of Saudi Arabia from October 2014 to December 2015. We utilized 30 flexor profundus tendons of young lambs with a width of 4 mm. All tendons were repaired with a 4-strand repair technique using 4/0 polypropylene core sutures. In group I (n=10 tendons), 2 separate figure-of-eight sutures were applied. In group II (n=10 tendons), simple locking sutures were added to the corners of 2 separate figure-of-eight sutures. In group III (n=10 tendons), the locked cruciate repair was used. All tendon repairs were tested to single-cycle tensile failure.Results:There was no significant difference between groups II and III with regards to gap and breaking forces; and all forces of these 2 groups were significantly higher than the forces in group I.Conclusion:It was concluded that 4 mm-wide pediatric flexor tendons allow a 4-strand repair and the use of 4/0 sutures. The use of locking sutures increases the tensile strength to values that may allow protective mobilization in children.

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Flexor tendon injuries in the child

Cited by 35 publications

References 47 publications

Early mobilization compared with immobilization after repair of a flexor tendon injury in children: A retrospective long time follow-up

Early mobilization compared with immobilization after repair of a flexor tendon injury in children: A retrospective long time follow-up

Beugesehnenverletzungen

A biomechanical study of pediatric flexor profundus tendon repair

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