[Primary suturing of zone II flexor tendons (103 digits). Results and Kleinert's limitations]. 1986

F Langlais, and Y Gibon, and J P Canciani, and J M Thomine

One hundred and sixty-two instances of traumatic division of the flexor tendons in zone 2 occurring in 103 injured digits were studied in 88 patients with at least 6 months follow-up. Motion and sensibility studies as well as trophic evaluation were available for all patients. Sixty-eight patients underwent repair according to Kleinert's technique. Overall results in these cases showed a 58% rate of "satisfactory" results versus 34% when classic techniques had been employed (35 cases). Kleinert's technique afforded the highest percentage of "good" results (75%) when tendon division was isolated whereas the rate of "good" results dropped to 23% when the injury went through to the floor of the digital tunnel. Complications included joint stiffness due to adhesions (19%) mainly related to the magnitude of the initial trauma, fixed flexion deformities (15%) and secondary rupture of the tendon (7%). Excision of the superficial flexor tendon was invariably associated with a poor results. Secondary treatment of these lesions was disappointing. While we agree that Kleinert's operative technique be used whenever feasible, semipassive mobilization as indicated by Kleinert, should however be reserved for isolated lesions in cooperative patients treated in centers where closely supervised rehabilitation is available. Immobilization of the interphalangeal joints in flexion together with their separate passive mobilization according to the method of Duran and Strickland, may reduce the number of complications observed with Kleinert's technique in the following circumstances; severe lesions (groups 3 A, 3 B), inadequate healing, an uncooperative patient. It is of paramount importance to look for and repair concomitant nerve injuries. Inadequate nerve management alone in these circumstances can account for up to 25% of overall functional failures. When bilateral vascular lesions are present, it is essential that vascular repair of the digital arteries be performed at once. Unilateral arterial insult does not seem to significantly affect results in terms of active motility.

UI MeSH Term Description Entries
D008722 Methods A series of steps taken in order to conduct research. Techniques,Methodological Studies,Methodological Study,Procedures,Studies, Methodological,Study, Methodological,Method,Procedure,Technique
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005069 Evaluation Studies as Topic Works about studies that determine the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. Critique,Evaluation Indexes,Evaluation Methodology,Evaluation Report,Evaluation Research,Methodology, Evaluation,Pre-Post Tests,Qualitative Evaluation,Quantitative Evaluation,Theoretical Effectiveness,Use-Effectiveness,Critiques,Effectiveness, Theoretical,Evaluation Methodologies,Evaluation Reports,Evaluation, Qualitative,Evaluation, Quantitative,Evaluations, Qualitative,Evaluations, Quantitative,Indexes, Evaluation,Methodologies, Evaluation,Pre Post Tests,Pre-Post Test,Qualitative Evaluations,Quantitative Evaluations,Report, Evaluation,Reports, Evaluation,Research, Evaluation,Test, Pre-Post,Tests, Pre-Post,Use Effectiveness
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006227 Hand Deformities, Acquired Deformities of the hand, or a part of the hand, acquired after birth as the result of injury or disease. Acquired Hand Deformities,Acquired Hand Deformity,Deformities, Acquired Hand,Deformity, Acquired Hand,Hand Deformity, Acquired
D006230 Hand Injuries General or unspecified injuries to the hand. Injuries, Hand,Hand Injury,Injury, Hand
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000267 Tissue Adhesions Pathological processes consisting of the union of the opposing surfaces of a wound. Adhesions, Tissue,Surgery-Induced Tissue Adhesions,Surgical Adhesions,Adhesion, Surgery-Induced Tissue,Adhesion, Surgical,Adhesion, Tissue,Adhesions, Surgery-Induced Tissue,Adhesions, Surgical,Surgery Induced Tissue Adhesions,Surgery-Induced Tissue Adhesion,Surgical Adhesion,Tissue Adhesion,Tissue Adhesion, Surgery-Induced,Tissue Adhesions, Surgery-Induced
D013708 Tendon Injuries Injuries to the fibrous cords of connective tissue which attach muscles to bones or other structures. Injuries, Tendon,Injury, Tendon,Tendon Injury
D059348 Peripheral Nerve Injuries Injuries to the PERIPHERAL NERVES. Peripheral Nerve Injury,Nerve Injuries, Peripheral,Nerve Injury, Peripheral

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