Revista de la Asociación Argentina de Ortopedia y Traumatología
versión On-line ISSN 1852-7434
DE CARLI, Pablo et al. Flexor tendon repair in zone ii with a new technique Using absorbable suture and early active Mobilization. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2011, vol.76, n.4, pp. 288-296. ISSN 1852-7434.
Background: The aim of this study is to describe a new primary flexor tendon repair technique using absorbable suture, followed by early active/passive mobilization. Methods: Nineteen patients (13 fingers, 7 thumbs) with complete flexor digitorum profundus (zone II) or flexor pollicis longus (zone II-III) rupture were retrospectively evaluated. Mean age: 36 years. Tendon repair: 4-strand double-modified Kessler core suture technique in vertical position and circumferential suture using absorbable polydioxanone, followed by combined active/passive mobilization. Comparative total active motion (TAM) and pulp-palm distance were evaluated. Function was calculated using Strickland-Glogovac criteria (fingers), and Buck-Gramcko system (thumbs). Results: Mean follow-up: 23 months (7-47 months). One tendon repair ruptured. Mean TAM: 146° in fingers and 44° in thumbs (contralateral: 174° and 62°). Functional results: excellent in 9 fingers, good in 10, and poor in 1 finger. Mean pulp-palm distance: 0.1cm. All were satisfied. Conclusions: Advantages: technically simpler than others, preserves biomechanical properties of dorsal suture, avoids problems associated with foreign body implantation, and may decrease intratendinous vascular damage. Preliminary results suggest that this new technique using absorbable suture combined with early active/ passive mobilization is safe and effective for primary repair of flexor tendons in the "no man's land" of the hand.
Palabras llave : Flexor tendon; Tendon repair; Absorbable suture; Active mobilization; Zone II.