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Updated: Dec 31, 2025
Murine Flexor Tendon Injury and Repair Surgery
Published on: September 19, 2016
[Treatment of flexor tendon injuries in children]
R-T Moeller1, M Mentzel2, D Vergote2
1Klinik für Unfall‑, Hand‑, Plastische und Wiederherstellungschirurgie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland. richard-tobias.moeller@uniklinik-ulm.de.
Insights
Pediatric flexor tendon injuries require prompt surgical exploration. Treatment involves a 2-strand core stitch and tailored post-operative care based on age, yielding comparable results to other methods.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Traumatology
Background:
- Flexor tendon injuries in children are uncommon but can lead to significant growth disturbances if untreated.
- Accurate diagnosis and timely intervention are crucial for optimal outcomes in pediatric hand injuries.
- Open injuries in pediatric hands warrant liberal indications for surgical exploration.
Purpose of the Study:
- To outline an evidence-based approach for managing flexor tendon injuries in children.
- To describe specific surgical techniques and rehabilitation protocols for pediatric flexor tendon injuries.
- To compare the efficacy of different treatment and aftercare strategies.
Main Methods:
- Application of the Ulm algorithm for flexor tendon repair in pediatric patients.
- Utilizing a 2-strand core stitch technique followed by a continuous circular suture.
- Implementing age-specific postoperative immobilization (3 weeks for <6 years) or dynamic aftercare (5 weeks for >6 years).
Main Results:
- The described treatment protocol provides effective management for pediatric flexor tendon injuries.
- Postoperative outcomes are comparable to those achieved with alternative rehabilitation protocols.
- Age-appropriate immobilization and dynamic aftercare contribute to successful recovery.
Conclusions:
- Surgical exploration should be liberally considered for all open flexor tendon injuries in children.
- The Ulm algorithm and age-specific rehabilitation offer a reliable treatment strategy.
- Early and appropriate management of pediatric flexor tendon injuries prevents long-term complications.
Abstract:
Injuries to the flexor tendons in children are less common than in adults. The clinical examination and diagnostics require extensive experience. Leaving flexor tendons untreated will result in growth disorders of the affected finger. Therefore, the indications for operative exploration of any type of open injury in a child's hand should be liberally applied. As for adults the primary treatment of flexor tendon injuries as an emergency is rarely indicated. In the recent literature various tendon suture techniques and rehabilitation protocols have been differently assessed. According to the Ulm algorithm flexor tendon injuries in children are treated by a 2-strand core stitch technique followed by a continuous circular suture. Children under 6 years of age are postoperatively immobilized for 3 weeks with a fist bandage. Children older than 6 years are treated like adults with a dynamic aftercare as described by Kleinert for 5 weeks. The results are comparable with those of other aftercare protocols.
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