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[Surgery and rehabilitation of flexor tendons injuries in zone 1 and 2]
S Coppolino1, F Lupo, F Quatra
1Gruppo Interdivisionale di Chirurgia della Mano, Policlinico Universitario, Messina, Italy.
Background:
Prevention of adhesions that restrain tendon gliding is based on early mobilization techniques. Such approach, anyway, does not guarantee positive outcomes.
Methods:
Seventy-five patients for a total number of 98 flexors tendons have been treated at the University Hospital of Messina between December 1993 and January 2000. Twenty-five patients, for a total number of 26 tendons, have been seen at follow-up. Seventeen lesions involved zone 2 and 9 involved zone 1. The modified Kessler suture has been generally used. All the repairs have been followed by an adequate early mobilization protocol, according to Kleinert (passive extension/active flexion) in nine patients and according to Risitano and Savage (active extension/active flexion) in 16.
Results:
Minimum follow-up was 12 months. We present results with an assessment performed according to Strickland and to Elliot for lesion in zone 1 and according to Strickland and using Total Active Motion of the finger for lesions in zone 2.
Conclusions:
The suturing technique and mobilization protocol did not affect results, but we made some considerations about respective advantages and disadvantages of either method.