Results of flexor tendon surgery in zone II. 1985

J W Strickland

In this article we have attempted to analyze the results of Zone II flexor tendon repair, staged flexor tendon reconstruction, and tenolysis based on cases taken from a single hand surgical practice. Formulas have been offered to determine the percentage return of motion at the PIP and DIP joints utilizing the total active and passive motion measurements. Variation in the formulas for each procedure are necessitated by the preoperative active and passive motion. A common classification system based on the percentage return following each procedure has also been utilized. By employing these assessment methods on digits of our patients who underwent flexor tendon repairs, we achieved the following results: Digits undergoing primary flexor tendon repair in Zone II with postoperative controlled passive motion techniques returned 56 per cent excellent or good function, with 13 per cent in the poor category and 4 per cent experiencing tendon rupture. Staged flexor tendon reconstruction returned 40 per cent excellent or good results with 66 per cent categorized as excellent, good, or fair. Twenty-eight per cent remained in the poor classification, with 7 per cent having ruptures. These results were substantially upgraded by tenolysis of the tendon grafts following Stage II in 47 per cent of all digits. Tenolysis was an effective procedure following a repair or graft and was found to return 67 per cent excellent or good results when carried out for adherent tendon repairs, with 10 per cent in the poor category and an 8 per cent rupture rate. A 65 per cent excellent or good return followed tenolysis of flexor tendon grafts, with 12 per cent judged poor and 8 per cent incidence of rupture. An analysis of the theoretical results of 100 consecutive Zone II flexor tendon repairs following multiple procedures for those digits that had unsatisfactory initial results indicated that, under ideal circumstances, as high as 96 per cent of all digits might be expected to return flexor performance in the excellent or good categories. I acknowledge that the results of flexor tendon procedures are strongly influenced by a wide array of factors, including the patient's age and motivation, the preoperative status of the digit, surgical technique, and postoperative management. An effort has been made here to minimize the variables by including patients taken from a single hand surgical practice and managed, to a large extent, by the same surgeon.(ABSTRACT TRUNCATED AT 400 WORDS)

UI MeSH Term Description Entries
D007103 Immobilization The restriction of the MOVEMENT of whole or part of the body by physical means (RESTRAINT, PHYSICAL) or chemically by ANALGESIA, or the use of TRANQUILIZING AGENTS or NEUROMUSCULAR NONDEPOLARIZING AGENTS. It includes experimental protocols used to evaluate the physiologic effects of immobility. Hypokinesia, Experimental,Experimental Hypokinesia,Experimental Hypokinesias,Hypokinesias, Experimental
D009068 Movement The act, process, or result of passing from one place or position to another. It differs from LOCOMOTION in that locomotion is restricted to the passing of the whole body from one place to another, while movement encompasses both locomotion but also a change of the position of the whole body or any of its parts. Movement may be used with reference to humans, vertebrate and invertebrate animals, and microorganisms. Differentiate also from MOTOR ACTIVITY, movement associated with behavior. Movements
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
D005384 Finger Joint The articulation between the head of one phalanx and the base of the one distal to it, in each finger. Interphalangeal Joint of Hand,Interphalangeal Joint of Finger,Finger Interphalangeal Joint,Finger Interphalangeal Joints,Finger Joints,Hand Interphalangeal Joint,Hand Interphalangeal Joints,Joint, Finger,Joints, Finger
D005385 Fingers Four or five slender jointed digits in humans and primates, attached to each HAND. Finger
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
D012826 Silicone Elastomers Polymers of silicone that are formed by crosslinking and treatment with amorphous silica to increase strength. They have properties similar to vulcanized natural rubber, in that they stretch under tension, retract rapidly, and fully recover to their original dimensions upon release. They are used in the encapsulation of surgical membranes and implants. Elastomers, Silicone,Rubber Silicone,Silicone Rubber,Elastosil,Microfil,SE-30,Elastosils,Microfils,SE 30,SE30,Silicone Elastomer
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
D013710 Tendons Fibrous bands or cords of CONNECTIVE TISSUE at the ends of SKELETAL MUSCLE FIBERS that serve to attach the MUSCLES to bones and other structures. Endotenon,Epotenon,Tendons, Para-Articular,Tendons, Paraarticular,Endotenons,Epotenons,Para-Articular Tendon,Para-Articular Tendons,Paraarticular Tendon,Paraarticular Tendons,Tendon,Tendon, Para-Articular,Tendon, Paraarticular,Tendons, Para Articular

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