Outcomes of flexor tendon repairs in zone 2 subzones with early active mobilization

J Hand Surg Eur Vol. 2017 Nov;42(9):896-902. doi: 10.1177/1753193417715213. Epub 2017 Jun 13.

Abstract

We report on the outcomes of flexor tendon repair in zone 2 subzones with early active mobilization in 102 fingers in 88 consecutive patients. There were 28, 53, 15, and six fingers with repairs in zones 2A to 2D, respectively. Rupture of the repair occurred in four fingers, all in zone 2B. Excluding those with repair ruptures, the mean total active motion was 230° (range 143°-286°). Evaluated with Tang's criteria, the outcomes were ranked excellent in 39 fingers, good in 46, fair in ten, poor in three, and failure in four. The outcomes in zone 2C were significantly inferior to those in zones 2B and 2D ( p = 0.02). Our results suggest that the tendon laceration in the area covered by the A2 pulley (zone 2C) is the most difficult area to obtain satisfactory active digital motion and tendon repair in zone 2B is the area where the risk of rupture is highest.

Level of evidence: IV.

Keywords: Early active mobilization; flexor tendon injury; six-strand technique; subzone; zone 2.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Exercise Therapy
  • Female
  • Finger Injuries / rehabilitation*
  • Finger Injuries / surgery*
  • Humans
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Recovery of Function
  • Retrospective Studies
  • Suture Techniques
  • Sutures
  • Tendon Injuries / rehabilitation*
  • Tendon Injuries / surgery*
  • Treatment Outcome
  • Young Adult