The investigation of the repair of acute trauma to flexor tendons of Zone II

Background: Despite the tremendous investigation in the areas of flexor tendon anatomy,
biomechanics, nutrition, healing and adhesion formation return of satisfactory digital performance
following for the hand surgeons.
Methods and Materials: This is a descriptive cross sectional study which investigates the results of
primary repair of acute trauma (less than 10 days) to flexor tendons of zone II.
After initial exam, the operation was done by an experienced hand surgeon. The operation was
done mostly in first 24 hours (primary repair) and in some cases in 10 days (delayed primary
repair). All FDP lacerations were repaired with 4/0 nylon modified Kessler core suture and 6/0
nylon circumferential running suture. Post operation mobilization was done by using a dorsal splint
in 40 degree wrist flexion and 60 degree metacarpophalengeal flexion and interphalengeal extent
ion from finger tips to elbow.
Early motion was begun one or two days after operation with modified Kleinert regimen. in
children who could not cooperate in motion , long cast was used all patens completed follow up
every two weeks for 6 weeks and every three weeks for another 6 weeks . The results were evaluated
to buck –gramcko classification system at least 3 months after treatment. The results analyze was
done using SPSS software and Kruskal –Wallis and man Whitney tests.
Results: The study was done on 37 patients with injured flexor tendons, %67 male and %33
female with average age of 26. The results were excellent in 22 (%37.3) and good in 21 (%35.6 and
fair in %20.3 and bad in 4 (%6.8). The most common complications were mild to moderate
adhesion (%45) and cold intolerance (%36). Results of tendons repair were better in females than
those in males (p value =%0.399). The best result was repair of isolated FDS. Results of repairing
both FDP and FDS were the same as repairing FDP and resecting FDS (P value =%0.0006) final
results were better in non dominant had (p value =%0.0025).
Conclusions: The repair of flexor tendons of zone II has various side effects and demands more
and more primary repair measures on the part of an experienced surgeon.