Prospective Morphologic and Dynamic Assessment of Deep Flexor Tendon Healing in Zone II by High-Frequency Ultrasound: Preliminary Experience

Abstract

Preliminary data of this study indicate a better clinical outcome if a sutured tendon maintains a spindlelike shape and increased power Doppler signal. This might indicate a predominantly intrinsic healing pattern with reduced adhesion formation. Ultrasound morphology, power Doppler signal, and tendon excursion may be helpful tools to rate tendon healing and to establish individually modified rehabilitation protocols.

Evaluation of Rehabilitation of Surgically Repaired Flexor Hand Tendons and Ultrasonographic Follow up of Their Healing

“…Echogenicity of the healing flexor tendon was significantly improved after the 12th week when compared with the 4th and 8th weeks. This is in agreement with the results of Puippe et al [23] who found that echogenicity changes during the healing process toward more hyperechogenic structures inside the suture site. They explained their results by stages of tendon repair; in the early inflammatory and proliferative stages, tendons seemed predominantly hypoechogenic, which can be explained by the high amount of blood vessels and oedema, but in the remodelling phase, the increase of organised collagen fibres causes a higher echogenicity within the tendon.…”

Flexor tendon repair in the hand with the M-Tang technique (without peripheral sutures), pulley division, and early active motion

“…In selected cases as explained in Figure 1, we partially resect the FDS tendon, that is, one slip when it is partially divided. These changes of pulleys management and FDS management are based on acceptance that the tendon diameter at a suture site increases by 1.6-fold after repair (Puippe et al., 2011).…”

Sonographic study of repair, gapping and tendon bowstringing after primary flexor digitorum profundus repair in zone 2

“…High-frequency ultrasound is used to investigate tendon repairs because it is non-invasive, repeatable and relatively inexpensive (Corduff et al., 1994; Damert et al., 2006; Marlborough et al., 2015; Puippe et al., 2011). Ultrasound can also be used to assess locations of flexor tendon injuries and measuring tendon excursion (Puippe et al., 2011).…”