Early active motion program for injuries of the flexor tendon in the zone II region

Early active motion program for injuries of the flexor tendon in the zone II region

54 THE JOURNAL 103. USE OF VEIN GRAFI- AS A TENDON SHEATH SUBSTITUTE FOLLOWING TENDON REPAIR: AN INNOVATIVE TECHNIQUE IN TENDON SURGERY S.R. Moosav...

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54

THE JOURNAL

103. USE OF VEIN GRAFI- AS A TENDON SHEATH SUBSTITUTE FOLLOWING TENDON REPAIR: AN INNOVATIVE TECHNIQUE IN TENDON SURGERY

S.R. Moosavi’, A.R. Kalantar Motamedi*. ‘Department of General and Vascular Surgery and Traumatology, Shohada Medical Center; Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Attending Vascular Surgeon and Assistant Professor of Surgeq Huzrat Rusoul Medical Complex, Iran University of Medical Sciences, Tehran, Irun

Objectives: This is a new technique for managing tendon repair which can improve the results of existing methods. Methods: 105 patient with new or old tendon injuries or complications of previous repair underwent tendon repair by modified Kessler method portion of the saphenous vein was used to cover the repaired tendon. 90 patient had flexor tendon injuries, which involved zone 1 to 5, and 15 patient had extensor tendon injuries (zone 5 to 7). A modified Kessler technique with 3-O prolene was used for the core suture. Afterwards, a running 6-O nylon or prolene epitendinous suture was used. After the tendon repair, a segment of vein, which the tendon had been passed through prior to the repair, was used as a substitute tendon sheath. A 6-O prolene was used for anastomosis of the proximal and distal ends of the sheath defect to the interposed segment of autogenous or frozen vein. Results: Our preliminary results appear encouraging when compared with outcomes achieved by conventional tendon repair techniques. Conclusions: Because this technique reduces adhesion formation, may also improve tendon nourishment, and also decreases the need of intensive physiotherapy, it should be used routinely in the future.

104. EARLY ACTIVE MOTION RESULTS IN FASTER (AND BE’ITER) RECOVERY FROM EXTENSOR TENDON INJURIES

Henk Giele ‘, Sonia Ranelli *. ‘Radcltfle InJirmary, Woodstock roud, 0X26: Australia

Perth, Australiu; 2Royal ‘Perth Hospital, Perth,

A prospective randomised trial of early active motion versus dynamic outrigger splinting for the RhdbihtUiOn of extensor tendon

OF HAND

SURGERY

Vol..

?XR SUPPLEMENT

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injuries in zones 4-8 was performed.50 patients who had extensor tendon repairs were enrolled, and the therapy regimes randomised. E‘arly active motion consisted of a resting splint with regular active exercises commencing on the first post-operative day. Dynamic outrigger splinting consisted of a dorsally based splint with elastic traction to assist passive extension with active flexion. Patients were assessed regularly and linally at 3 months or discharge. Patients on the early active motion program achieved a greater range of movement faster and with less therapy then those on the passive program. Although the final range of movement in the 2 groups was the same the time and effort taken to achieve the result was significantly different.

105. EARLY ACTIVE MOTION PROGRAM FOR INJURIES OF THE FLEXOR TENDON IN THE ZONE II REGION

Mehmet Alp, R. Caykusu, B. Tander, L. Yalcin. Manus-Hand Group, Sakayik Sok. Esen Apt No. 57 D. I Nisantasi 40200. 0212 Istanbul. Turkey

Introduction: One of the most important problems in hand surgery is injury of the flexor tendon in the Zone II region. In this study, we analyzed the clinical results of our early active motion programme in Zone II flexor tendon injuries. Materials and methods: Between the years 1996-2002,41 fingers of 3 I patients, of which 17 were male and 14 female, with Zone II flexor tendon injury who underwent surgery then rehabilitation and using an early active motion programme by the Manus-Hand Group were included in this study. The patients who did not continue the programme were excluded. The mean follow-up time was 2X months (6-76 months). The rehabilitation programme was started three days after surgery. Results: 84.6% were excellent and good, 15.4% were fair. Two patients had tendon rupture during the rehabilitation period. These patients were re-operated upon and returned to the early active motion program. They had good results. Conclusion: An early active motion programme flexor of tendon rehabilitation is a good choice but it requires a strong suture technique and a very good therapist to patient relationship.