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Updated: Mar 3, 2026
Murine Flexor Tendon Injury and Repair Surgery
Published on: September 19, 2016
Long-term outcome of paediatric flexor tendon injuries of the hand
Georg Singer1, Thomas Zwetti1, Ruth Amann1
1Department of Paediatric and Adolescent Surgery, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.
Insights
Dynamic rehabilitation protocols show good to excellent outcomes for paediatric hand flexor tendon injuries. This approach benefits children of all ages, regardless of injury location, improving functional recovery after surgery.
Area of Science:
- Orthopedic Surgery
- Pediatric Hand Surgery
- Rehabilitation Medicine
Background:
- Paediatric flexor tendon injuries of the hand present unique challenges in treatment and rehabilitation.
- The optimal post-operative management strategy remains a subject of debate within the medical community.
Purpose of the Study:
- To assess the clinical outcomes of paediatric patients treated for flexor tendon injuries using a dynamic postoperative protocol.
- To evaluate the effectiveness of this protocol across different age groups and injury zones.
Main Methods:
- Retrospective analysis of 144 paediatric patients (mean age 9.1 years) with 267 flexor tendon injuries treated between 1999 and 2011.
- Follow-up included clinical examination, Total Active Motion (TAM) scores, Buck-Gramcko scores, and linear measurement system.
- Data analyzed for outcomes based on age, injury zone, and tendon type (FDS, FDP, FPL).
Main Results:
- Excellent or good outcomes (based on TAM scores) were achieved in 41% and 48% of patients, respectively.
- No statistically significant difference in outcomes was observed between younger (≤6 years) and older (>6 years) children.
- The zone of injury did not impact objective outcome measures.
Conclusions:
- Dynamic mobilization protocols yield good to excellent results for paediatric hand flexor tendon injuries.
- This rehabilitation approach is effective irrespective of patient age or the specific zone of tendon injury.
- The findings support the use of dynamic protocols for consistent functional recovery in pediatric patients.
Abstract:
The ideal rehabilitation regimen of paediatric flexor tendon injuries of the hand is discussed controversially. In this study, the clinical outcome of paediatric patients with flexor tendon injuries treated with a dynamic postoperative protocol was assessed. All children with flexor tendon injuries of the hand who were treated by a dynamic postoperative protocol between 1999 and 2011 were included. Patients were invited for a follow-up examination consisting of clinical examination, the TAM and Buck-Gramcko scores, and the linear measurement system. In total, 144 patients (mean age 9.1 years, range 1-17 years) with 267 flexor tendon injuries (128 flexor digitorum superficialis (FDS), 126 flexor digitorum profundus (FDP) and 13 flexor pollicis longus (FPL)) of 191 digits were treated. Of them, 43% (n = 62; 49 male, 13 female) with 88 digits (thumb n = 4, index finger n = 17, middle finger n = 25, ring finger n = 20, small finger n = 22) with 123 injured tendons (FDS n = 62, FDP n = 57, FPL n = 4) were included in the follow-up at a mean post-operative interval of 7.2 years (range 1-13 years). Using the Total Active Motion (TAM) score, an excellent and good outcome could be achieved in 41% and 48% of the patients, respectively. The zone of injury did not influence the objective outcome measures. Subjective and objective outcomes were not statistically different between young children (≤6 years) and older children (>6 years). The present study demonstrates good to excellent outcome in a large cohort of paediatric patients with flexor tendon injuries of the hand treated with a dynamic mobilisation protocol irrespective of patient age.
