Abstract | OBJECTIVE: Flexor tendon repair by direct suture, providing tendon function and mechanical properties and allowing postoperative active extension and flexion. INDICATIONS: Flexor tendon laceration in all zones, when primary healing and a good functional outcome can be expected. CONTRAINDICATIONS: Florid and chronic infection. Lack of skill, instruments, or manpower. Tension-free suture is not feasible. Severe soft-tissue problems. Mantero suture in case of coexistent artery injury. SURGICAL TECHNIQUE: Hand surgical incisions and approach to the tendon. Opening of the tendon sheath in the region of oblique pulley. A four-strand core suture consisting of two locked two-strand sutures and a circumferential epitendon cross-stitch suture are performed. Lacerations in zone I with a tendon stump shorter than 1 cm require a Mantero suture and avulsions require a pull-out suture technique. POSTOPERATIVE MANAGEMENT: Active flexion and active extension in a dorsal wrist cast. RESULTS: The clinical outcome studies after repair of zone II flexor tendon injuries using a multiple-strand suture technique describe 69-96% excellent and good results.
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Authors | Christine Stephan, Ali Saalabian, Jörg van Schoonhoven, Karl-Josef Prommersberger |
Journal | Operative Orthopadie und Traumatologie
(Oper Orthop Traumatol)
Vol. 20
Issue 1
Pg. 44-54
(Mar 2008)
ISSN: 0934-6694 [Print] Germany |
Vernacular Title | Die primäre Naht der Fingerbeugesehnen. |
PMID | 18338118
(Publication Type: English Abstract, Journal Article)
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Topics |
- Casts, Surgical
- Finger Injuries
(surgery)
- Hand
(surgery)
- Humans
- Lacerations
(surgery)
- Postoperative Care
- Preoperative Care
- Suture Techniques
- Tendon Injuries
(surgery)
- Time Factors
- Treatment Outcome
- Wound Healing
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