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A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
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[Flexor and extensor tendon injuries in children (primary and secondary repair)]

A Dinh1

  • 1Urgences-mains de l'Est Parisien, clinique La Francilienne, 77340 Pontault-Combault, France.

Chirurgie De La Main
|May 1, 2013
PubMed

Insights

Flexor tendon repair in children requires a one-month cast immobilization, especially for young children. Extensor tendon injuries in children under five may need Kirschner wire fixation for optimal healing.

Area of Science:

  • Orthopedic surgery
  • Pediatric hand surgery
  • Tendon repair

Context:

  • Pediatric tendon injuries, both flexor and extensor, present unique management challenges.
  • Postoperative immobilization and rehabilitation protocols differ between pediatric and adult patients.
  • Limited cooperation in young children impacts adherence to traditional postoperative regimens.

Purpose:

  • To outline specific technical considerations and postoperative management strategies for flexor and extensor tendon injuries in pediatric patients.
  • To evaluate the efficacy of different immobilization and early mobilization techniques in pediatric tendon repair.
  • To provide evidence-based recommendations for optimizing outcomes in children undergoing tendon surgery.

Summary:

  • Flexor tendon repair in children shares technical principles with adults but necessitates longer immobilization (one month) with a cast, particularly in young children due to cooperation issues.
  • Early mobilization programs show no significant benefit in young children but are recommended for adolescents, similar to adults.
  • Dynamic splinting is generally unnecessary for pediatric extensor tendon injuries.
  • For complete extensor tendon transection in zones I-III, especially in children under five, Kirschner wire transfixation of the IP joint in extension during immobilization is crucial.

Impact:

  • This guidance can help pediatric orthopedic surgeons refine postoperative care for tendon injuries, potentially reducing complications like ruptures.
  • Standardizing management protocols may lead to improved functional outcomes for children with hand tendon injuries.
  • Differentiated approaches for young children versus adolescents ensure age-appropriate rehabilitation and better long-term results.

Keywords:
ChildrenEnfantExtensor tendonFlexor tendonRéparation chirurgicaleSurgical repairTendons extenseursTendons fléchisseurs

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