Treatment of flexor tendon injuries: surgeons' perspective

Medical researchers continue to explore the flexor tendon's response to injury and repair. In recent years, hand surgery and therapy publications have focused on the biomechanics of suture techniques and the benefits of early postoperative motion on surgically repaired flexor tendons. Laboratory and clinical studies have shown that stronger suture techniques can withstand the strain of immediate active motion without a significant risk of tendon rupture or gap formation. Newly proposed therapy techniques and anatomic studies defining the effects of wrist and digital position on tendon excursion share the goals of achieving early motion and reducing restrictive adhesions. Clinical studies have evaluated the various imaging modalities used to diagnose postoperative adhesions. Other clinical surveys have detailed the use of pedicled autograft and allograft tendons in staged reconstruction. Histologic and immunologic researchers have concentrated on cellular activation patterns following tendon injury and the effects of pharmacologic agents, such as hyaluronan and aprotinin, on tendon healing and adhesion formation.