Early active mobilization for flexor tendons repaired using the double loop locking suture technique

Current suture techniques limit the postoperative management for flexor tendons. A double loop locking suture (DOLLS) technique has been described that provides sufficient in vitro strength (average 4,400 g) for early active mobilization of the flexor tendon. This paper details four cases in which the flexor digitorum profundus (FDP) tendons were repaired using the DOLLS technique. Early active mobilization was initiated 3 to 7 days postoperatively. Results were classified according to Strickland's formula. Two patients achieved excellent results, one a good result, and one a fair result. One rupture of a flexor digitorum superficialis (FDS) tendon, which had been repaired with a modified Kessler technique, occurred. Although this FDS tendon ruptured, the FDP tendon, which had been repaired with the DOLLS technique, remained intact. With the use of a protective splint, early active mobilization of tendons repaired by the DOLLS technique appears to be an effective method for postoperative management.