Flexor Tendon Repair in Zone 2 Followed by Early Active Mobilization

Baktır, Ali; Türk, Cemil Yıldırım; Kabak, Şevki; Şahin, Vedat; Kardaş, Y.

doi:10.1016/s0266-7681(96)80145-8

Cited by 109 publications

(59 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[2][3][4][5][6][7][8][9] Modern multistrand repairs and the addition of circumferential sutures have increased the tensile strength of repairs, 10 -13 suggesting that they are adequate to sustain forces in early active mobilization. 8,9,14,15 Many of these biomechanical tests have used the study of forces in FDP tendons during carpal tunnel release by Schuind et al 16 as a benchmark. Several investigators, however, feel that measurement of forces in tendons without prior trauma overlooks increases in work of flexion from postsurgical edema and adhesion formation.…”

mentioning

confidence: 99%

“…16 -19 In the clinical setting underestimation of forces after trauma and noncompliance during rehabilitation 20 may explain rupture rates up to 46% of the time, 9 with most between 5% and 10%. [3][4][5][6][7][8]14,15,[21][22][23][24][25] In addition to rupture early mobilization may lead to gapping with adhesion formation and diminished tendon glide and function.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The biomechanical analysis of a tendon fixation device for flexor tendon repair

Protopsaltis

Koff

et al. 2005

The Journal of Hand Surgery

View full text Add to dashboard Cite

mentioning

confidence: 99%

mentioning

confidence: 99%

The biomechanical analysis of a tendon fixation device for flexor tendon repair

Protopsaltis

Koff

et al. 2005

The Journal of Hand Surgery

View full text Add to dashboard Cite

“…Early motion after tendon repair, either active or passive, has been shown to reduce adhesion formation and increase the tensile strength of the healing tendon [5,10,33,40,41]. However, early motion may also have the detrimental effect of contributing to gap formation or suture rupture [ 13,27,36,38].…”

Section: Introductionmentioning

confidence: 99%

Gliding characteristics of tendon repair in canine flexor digitorum profundus tendons

Zhao¹,

Amadio²,

Zobitz³

et al. 2001

Journal Orthopaedic Research

View full text Add to dashboard Cite

The gliding resistance between the flexor digitorum profundus (FDP) tendon and the proximal pulley system was measured using the method of S. Uchiyama, J.H. Coert, L. Berglund, P.C. Amadio, K.N. An (J. Orthop. Res. 13 (1995) 83) in 108 adult dog digits in vitro. The FDP tendons were then lacerated to 80% of their transverse section. Each tendon was repaired with one of the following six suture techniques: Kessler, modified Kessler, Savage, Lee, Becker and simple running suture alone. Each repaired tendon was then tested again using the same method. The Student-Newman-Keuls test for multiple comparisons was performed for statistical analysis. The average gliding resistances of the Kessler, Savage, and Becker repairs were significantly greater than the resistances of the Lee, modified Kessler, and running suture alone repairs (P < 0.05). The Lee suture technique had a significantly greater resistance than the modified Kessler repair and the running suture (P < 0.05). The results of the peak gliding resistance followed the same trends, except that the modified Kessler repair was significantly higher than the running suture alone (P < 0.05). Suture techniques with a multi-strand core suture, with knots located outside the tendon surface, and with multiple-loops on the tendon surface may result in increased gliding resistance between the tendon aiid pulley system after tendon repair.

show abstract

“…6,8,9 Early mobilization is thought to inhibit or disrupt adhesion formation and also to promote intrinsic healing and synovial diffusion, to produce stronger tissue than with immobilization. [8][9][10][11] Despite its benefits, however, the safety and effectiveness of current mobilization techniques remain major concerns. If early active motion is too aggressive, it may also have the detrimental effect of causing gap formation or suture rupture.…”

mentioning

confidence: 99%

Flexor Digitorum Profundus Tendon Tension during Finger Manipulation

Tanaka

Amadio

Zhao

et al. 2005

Journal of Hand Therapy

View full text Add to dashboard Cite

The purpose of this study was to measure the tension in the flexor digitorum profundus (FDP) tendon in zone II and the digit angle during joint manipulations that replicate rehabilitation protocols. Eight FDP tendons from eight human cadavers were used in this study. The dynamic tension in zone II of the tendon and metacarpophalangeal (MCP) joint angle were measured in various wrist and digit positions. Tension in the FDP tendon increased with MCP joint extension. There was no tension with the finger fully flexed and wrist extended (synergistic motion), but the tendon force reached 1.77 ± 0.43 N with the MCP joint hyperextended 45 degrees with the distal interphalangeal and proximal interphalangeal joints flexed. The combination of wrist extension and MCP joint hyperextension with the distal interphalangeal and proximal interphalangeal joints fully flexed, what the authors term ''modified synergistic motion,'' produced a modest tendon tension and may be a useful alternative configuration to normal synergistic motion in tendon rehabilitation.Flexor tendon injury is common and often results in disability, especially in the zone II region of the hand. 1-3 Early mobilization, either passive or active, starting within a few days of repair, has been shown to produce superior results to postoperative immobilization. 4-7 Early mobilization after tendon repair decreases adhesion formation and improves repair site strength, permitting more complete recovery of tendon excursion and digital range of motion. 6,8,9 Early mobilization is thought to inhibit or disrupt adhesion formation and also to promote intrinsic healing and synovial diffusion, to produce stronger tissue than with immobilization. 8-11

show abstract

Flexor Tendon Repair in Zone 2 Followed by Early Active Mobilization

Cited by 109 publications

References 31 publications

The biomechanical analysis of a tendon fixation device for flexor tendon repair

The biomechanical analysis of a tendon fixation device for flexor tendon repair

Gliding characteristics of tendon repair in canine flexor digitorum profundus tendons

Flexor Digitorum Profundus Tendon Tension during Finger Manipulation

Contact Info

Product

Resources

About