Functional evaluation after primary flexor tendon repair in zone II.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Zone II flexor tendon injuries, often termed "no man's land," present significant challenges in hand reconstruction.
• Optimal functional restoration requires meticulous surgical repair and a well-defined postoperative rehabilitation protocol.

Purpose of the Study:

• To evaluate the efficacy of primary surgical treatment for flexor tendon lacerations in Verdan's zone II.
• To assess the impact of a specific postoperative rehabilitation program on functional outcomes.

Main Methods:

• A prospective study involving 19 patients (23 fingers) with zone II flexor tendon lacerations.
• Primary surgical repair of all injured tendons and nerves, followed by dorsal splinting.
• Initiation of a rehabilitation program involving passive flexion and active extension exercises between postoperative days 3-5.

Main Results:

• Eighteen patients (22 fingers) completed follow-up and were assessed using Strickland's classification.
• Excellent results were achieved in 15 cases, good in five, and fair in two.
• Concomitant digital nerve injuries were present in 12 cases and were also primarily repaired.

Conclusions:

• Primary repair of flexor tendons in zone II, coupled with early protected motion, leads to favorable functional recovery.
• A structured rehabilitation program emphasizing early protected and unrestricted joint motion is crucial for optimal hand function restoration.