[Acute flexor tendon surgery].

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.

• 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)

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