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Flexor tendon lacerations in zone V
R J Stefanich1, M D Putnam, C A Peimer
1Department of Orthopaedic Surgery, School of Medicine and Biomedical Sciences, University at Buffalo, N.Y.
The Journal of Hand Surgery
|March 1, 1992
Summary
Flexor tendon repair in zone V, using the Kleinert protocol, shows variable hand function recovery. While many regain strength and flexion, some experience lasting extension deficits and require further intervention.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Rehabilitation Medicine
Background:
- Zone V flexor tendon injuries present unique challenges in hand function recovery.
- The Kleinert protocol is a common rehabilitation approach for these injuries.
Purpose of the Study:
- To evaluate long-term functional outcomes and complications in patients with zone V flexor tendon lacerations rehabilitated with the Kleinert protocol.
Main Methods:
- Retrospective study of 23 patients with zone V flexor tendon lacerations.
- Average follow-up of 46 months post-trauma.
- Assessment of subjective hand function, return to work, pinch/grip strength, active motion, and sensibility.
Main Results:
- Subjective normal hand function reported in only 8 patients.
- Pinch and grip strength recovered to 85% and 79% respectively.
- Full digital flexion regained by 16 patients, but average extension loss was 25% at the wrist and 10% in digits.
- Complications included tendon ruptures and limited motion; 4 patients required tenolysis.
Conclusions:
- The Kleinert protocol yields mixed long-term results for zone V flexor tendon injuries.
- Modified rehabilitation techniques may be beneficial for noncompliant patients or those with intrinsic muscle weakness.