Strong Digital Flexor Tendon Repair, Extension-Flexion Test, and Early Active Flexion

Wide awake surgery for flexor tendon primary repair: A literature review

“…Different factors have been taken in consideration regarding the strength of the repairing bowstringing, 13 and the execution of a digital extension-flexion test during surgery. 14 Up to a decade ago this surgery was performed under general anesthesia, brachial plexus block or local anesthesia with sedation, and the flexion-extension test was performed passively by the surgeon. With the advent, in 2009, of wide-awake local anesthesia no tourniquet (WALANT) in tendon repair surgery, 15 the test is directly performed by the patient that can actively move the tendon during surgery, before skin suture.…”

The rare injury of a closed digital extensor tendon avulsion of the third finger at its musculotendinous junction: Case presentation and brief overview of literature with regard to general, specific and practicable aspects to extensor tendon surgery involving tendon transfer procedures

“…avoiding of adhesion formation with the skin or ingrowth of granulation tissue when the synovial sheath is damaged) in particular when the extrinsic blood supply via the paratenon and/or synovial sheath is damaged such as in posttraumatic conditions with or without infection ( Figures 9A-F, 10A-D, and 11A-E), postoperative complications ( Figures 12A-E), or also after required large soft tissue excision in case of a malignancy [13][14][15][16][17][18][19][20]. Furthermore, early active motion without limitations after tendon repair in the hand by a stable tendon suture seems to be more favorable to prevent adhesion-related contractures and results in better functional outcomes than in patients who must treated by static or dynamic splinting postoperatively when a lesser stable tendon suture does not allow early active motion [21][22][23][24]. Likewise, obtaining the centralizing and strengthen pulleys as well as the extensor retinaculum for the flexor and extensor tendons of the hand must always be aimed to avoid bowstring leading to functional loss and potentially resulting in contractures (Figures 12A-E and 13).…”

Letter to editor: The evidence-base for the management of flexor tendon injuries of the hand: Review

“…The practice has changed greatly over past 15 years, and venting of the critical pulley is as important as implementing a strong repair technique such as a 6-strand repairs [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. All publications of clinical outcomes in zone 2 in recent years indicate such as need [ 5 , [12] , [13] , [14] , [15] , [16] , [17] ]. The outcomes from our units also indicate the need, besides the reports from Europe and North America [ 12 , 13 , 16 ].…”