Primary Flexor Tendon Surgery. The Search for a Perfect Result

Hand Clinics

Volumn 29, Issue 2, 2013, Pages 191-206

  Elliot, David ^a   Giesen, Thomas ^a  

^a BROOMFIELD HOSPITAL   (United Kingdom)

Author keywords

Core and circumferential suture; Flexor tendons; Primary repair; Rehabilitation; Rupture and adhesions; Subzones; Venting pulleys; Zones

Indexed keywords

FLEXOR DIGITORUM SUPERFICIALIS MUSCLE; FLEXOR POLLICIS LONGUS MUSCLE; FLEXOR TENDON INJURY; HAND MUSCLE; HUMAN; INJURY SEVERITY; JOINT MOBILIZATION; MOBILIZATION; PATIENT COMPLIANCE; POSTOPERATIVE PERIOD; REHABILITATION CARE; REVIEW; SPLINT; SURGICAL APPROACH; SURGICAL TECHNIQUE; SUTURING METHOD; TENDON RECONSTRUCTION; TENDON SURGERY; TENDON SUTURE; TISSUE ADHESION;

BIOMECHANICAL PHENOMENA; FIBRIN TISSUE ADHESIVE; HAND; HUMANS; PATIENT COMPLIANCE; RECOVERY OF FUNCTION; RUPTURE; SPLINTS; SUTURE TECHNIQUES; SUTURES; TENDON INJURIES; TENDONS; TISSUE ADHESIONS; WOUND HEALING;

EID: 84877332309     PISSN: 07490712     EISSN: 15581969     Source Type: Journal    
DOI: 10.1016/j.hcl.2013.03.001     Document Type: Review

References (80)

1. Harmer T.W. Tendon suture. Boston Med Surg J 1917, 177:808-810.
2. Kulkarni M., Harris S.B., Elliot D. The significance of extensor tendon tethering and dorsal joint capsule tightening after injury to the hand. J Hand Surg Br 2006, 31:52-60.
3. Kirchmayr L. Zurtechnik der Sehnenaht. Zentralbl Chir 1917, 44:27-52.
4. Bunnell S. Repair of tendons in the fingers and description of two new instruments. Surg Gynecol Obstet 1918, 126:103-110.
5. Amadio P., An K.N., Ejeskar A., et al. IFSSH Flexor Tendon Committee report. J Hand Surg Br 2005, 30:100-116.
6. Tang J.B., Wu Y.F., Cao Y., et al. Gene therapy for tendon healing. Tendon surgery of the hand 2012, 59-70. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
7. Elliot D., Moiemen N.S., Flemming A.F., et al. The rupture rate of acute flexor tendon repairs mobilized by the controlled active motion regimen. J Hand Surg Br 1994, 19:607-612.
8. Yii N.W., Urban M., Elliot D. A prospective study of flexor tendon repair in zone 5. J Hand Surg Br 1998, 23:642-648.
9. Kwai-Ben I., Elliot D. "Venting" or partial lateral release of the A2 and A4 pulleys after repair of zone 2 flexor tendon injuries. J Hand Surg Br 1998, 23:649-654.
10. Harris S.B., Harris D., Foster A.J., et al. The aetiology of acute rupture of flexor tendon repairs in zones 1 and 2 of the fingers during early mobilization. J Hand Surg Br 1999, 24:275-280.
11. Sirotakova M., Elliot D. Early active mobilization of primary repairs of the flexor pollicis longus tendon. J Hand Surg Br 1999, 24:647-653.
12. Moiemen N.S., Elliot D. Early active mobilization of primary flexor tendon repairs in zone 1. J Hand Surg Br 2000, 25:78-84.
13. Elliot D. Primary flexor tendon repair-operative repair, pulley management and rehabilitation. J Hand Surg Br 2002, 27:507-514.
14. Elliot D., Harris S.B. The assessment of flexor tendon function after primary tendon repair. Hand Clin 2003, 19:495-503.
15. Sirotakova M., Elliot D. Early active mobilization of primary repairs of the flexor pollicis longus tendon with two Kessler two strand core sutures and a strengthened circumferential suture. J Hand Surg Br 2004, 29:531-535.
16. Dowd M.B., Figus A., Harris S.B., et al. The results of immediate re-repair of zone 1 and 2 primary flexor tendon repairs which rupture. J Hand Surg Br 2006, 31:507-513.
17. Giesen T., Sirotakova M., Copsey A.J., et al. Flexor pollicis longus primary repair: further experience with the Tang technique and controlled active mobilisation. J Hand Surg Eur 2009, 34:758-761.
18. Tang J.B., Shi D., Gu Y.Q., et al. Double and multiple looped suture tendon repair. J Hand Surg Br 1994, 17:699-703.
19. Savage R., Risitano G. Flexor tendon repair using a "six strand" method of repair and early active mobilisation. J Hand Surg Br 1989, 14:396-399.
20. Tang J.B., Xie R.G. Biomechanics of core and peripheral tendon repairs. Tendon surgery of the hand 2012, 35-48. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
21. Barrie K.A., Tomak S.L., Cholewicki J., et al. Effect of suture locking and suture caliber on fatigue strength of flexor tendon repairs. J Hand Surg Am 2001, 26:340-346.
22. Taras J.S., Raphael J.S., Marczyk S.C., et al. Evaluation of suture caliber in flexor tendon repair. J Hand Surg Am 2001, 26:1100-1104.
23. Mantero R., Bertolotti P., Badoini C. Il pull-out in "no man's land" e al canale digitale nelle lesioni dei flessori (metodo personale). Riv Chir Mano 1973-1974, 11:119-130.
24. Mantero R., Bertolotti P., Badoino C., et al. Revisione critica di 20 anni di esperienza sul trattamento delle lesioni dei flessori. Riv Chir Mano 1974-1975, 12:87-110.
25. Kessler I., Nissim F. Primary repair without immobilisation of flexor tendon division within the digital sheath. Acta Orthop Scand 1969, 40:587-601.
26. Tang J.B., Shi D. Subdivision of flexor tendon "no man's land" and different treatment methods in each sub-zone. A preliminary report. Chin Med J (Engl) 1992, 105:60-68.
27. Murphy F.G. Repair of laceration of flexor pollicis longus tendon. J Bone Joint Surg Am 1937, 19:1121-1123.
28. Urbaniak J.R. Repair of the flexor pollicis longus. Hand Clin 1985, 1:69-75.
29. Smith A.M., Evans D.M. Biomechanical assessment of a new type of flexor tendon repair. J Hand Surg Br 2001, 26:217-219.
30. Silfverskiöld K.L., May E.J. Flexor tendon repair in zone II with a new suture technique and an early mobilization program combining passive and active flexion. J Hand Surg Am 1994, 19:53-60.
31. Kasashima T., Kato H., Minami A. Factors influencing prognosis after direct repair of the flexor pollicis longus tendon: multivariate regression model analysis. Hand Surg 2002, 7:171-176.
32. Baer W., Jungwirth N., Wulle C., et al. The Mantero technique for flexor tendon repair-an alternative?. Handchir Mikrochir Plast Chir 2003, 35:363-367.
33. Lister G., Kleinert H.E., Kutz J.E., et al. Primary flexor tendon repair followed by immediate controlled mobilisation. J Hand Surg Am 1977, 2:441-451.
34. Wade P.J., Muir I.F., Hutcheon L.L. Primary flexor tendon repair: the mechanical limitations of the modified Kessler technique. J Hand Surg Br 1986, 11:71-76.
35. Kubota H., Aoki M., Pruitt D.L., et al. Mechanical properties of various circumferential tendon suture techniques. J Hand Surg Br 1996, 21:474-480.
36. Mason M.L. Primary and secondary tendon suture. A discussion of significance in tendon surgery. Surg Gynecol Obstet 1940, 70:392-404.
37. Verdan C. La reparation immédiate des tendons fléchisseursdans le canal digital. Acta Orthop Belg 1958, 24(Suppl III):15-23.
38. Tang J.B., Shi D., Zhang Q.G. Biomechanical and histological evaluation of tendon sheath management. J Hand Surg Am 1996, 21:900-908.
39. Strickland J.W., Glogovac S.V. Digital function following flexor tendon repair in Zone II: a comparison of immobilization and controlled passive motion techniques. J Hand Surg Am 1980, 5:537-543.
40. Barton N.J. Experimental study of optimal location of flexor tendon pulleys. Plast Reconstr Surg 1969, 43:125-129.
41. Idler R.S., Strickland J.W. The effects of pulley resection on the biomechanics of the PIP joint. J Hand Surg Am 1984, 9:595.
42. Savage R. The mechanical effect of partial resection of the digital fibrous flexor sheath. J Hand Surg Br 1990, 15:435-442.
43. Tomaino M., Mitsionis G., Basitidas J., et al. The effect of partial excision of the A2 and A4 pulleys on the biomechanics of finger flexion. J Hand Surg Br 1998, 23:50-52.
44. Mitsionis G., Bastidas J.A., Grewal R., et al. Feasibility of partial A2 and A4 pulley excision: effect on finger flexor tendon biomechanics. J Hand Surg Am 1999, 24:310-314.
45. Franko O.I., Lee N.M., Finneran J.J., et al. Quantification of partial or complete A4 pulley release with FDP repair in cadaveric tendons. J Hand Surg Am 2011, 36:439-445.
46. Wu Y.F., Zhou Y.L., Tang J.B. Relative contribution of tissue oedema and the presence of an A2 pulley to resistance to flexor tendon movement: an in vitro and in vivo study. J Hand Surg Eur 2012, 37:310-315.
47. Tang J.B. Indications, methods, postoperative motion and outcome evaluation of primary flexor tendon repairs in zone 2. J Hand Surg Eur 2007, 32:118-129.
48. Tang J.B. Treatment of the flexor tendon sheath and pulleys. Tendon surgery of the hand 2012, 88-97. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
49. Elliot D. Venting of the major pulleys. Tendon surgery of the hand 2012, 98-103. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
50. Elliot D. Clinical primary flexor tendon repair and rehabilitation. The Chelmsford experience. Tendon surgery of the hand 2012, 125-132. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
51. Small J.O., Brennen M.D., Colville J. Early active mobilisation following flexor tendon repair in zone 2. J Hand Surg Br 1989, 14:383-391.
52. Savage R. The influence of wrist position on the minimum force required for active movement of the interphalangeal joints. J Hand Surg Br 1988, 13:262-268.
53. Wilson S., Sammut D. Flexor tendon graft attachment: a review of methods and a newly modified tendon graft attachment. J Hand Surg Br 2003, 28:116-120.
54. Sood M.K., Elliot D. A new technique of attachment of flexor tendons to the distal phalanx without a button tie-over. J Hand Surg Br 1996, 21:629-632.
55. Sourmelis S.G., McGrouther D.A. Retrieval of the retracted flexor tendon. J Hand Surg Br 1987, 12:109-111.
56. Le Viet D. Flexor tendon lengthening by tenotomy at the musculotendinous junction. Ann Plast Surg 1986, 17:239-246.
57. Tang J.B. Flexor tendon repair in zone 2C. J Hand Surg Br 1994, 19:72-75.
58. Elliot D. Primary repair of the flexor pollicis longus tendon. Tendon surgery of the hand 2012, 186-193. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
59. Bainbridge L.C., Robertson C., Gillies D., et al. A comparison of post-operative mobilization of flexor tendon repairs with "passive flexion-active extension" and "controlled active motion" techniques. J Hand Surg Br 1994, 19:517-521.
60. Cullen K.W., Tolhurst P., Lang D., et al. Flexor tendon repair in zone 2 followed by controlled active mobilisation. J Hand Surg Br 1989, 14:392-395.
61. Baktir A., Türk C.Y., Kabak S., et al. Flexor tendon repair in zone 2 followed by early active mobilization. J Hand Surg Br 1996, 21:624-628.
62. Peck F.H., Bucher C.A., Watson S.J., et al. An audit of flexor tendon injuries in zone II and its influence on management. J Hand Ther 1996, 9:306-308.
63. Olivier L.C., Assenmacher S., Kendoff D., et al. Results of flexor tendon repair of the hand by the motion-stable wire suture by Towfigh. Arch Orthop Trauma Surg 2001, 121:212-218.
64. Klein L. Early active motion flexor tendon protocol using one splint. J Hand Ther 2003, 16:199-206.
65. Golash A., Kay A., Warner J.G., et al. Efficacy of ADCON-T/N after primary flexor tendon repair in Zone II: a controlled clinical trial. J Hand Surg Br 2003, 28:113-115.
66. Peck F.H., Kennedy S.M., Watson J.S., et al. An evaluation of the influence of practitioner-led hand clinics on rupture rates following primary tendon repair in the hand. Br J Plast Surg 2004, 57:45-49.
67. Su B.W., Solomons M., Lubbers L., et al. Device for zone-II flexor tendon repair. A multicenter, randomized, blinded, clinical trial. J Bone Joint Surg Am 2005, 87:923-935.
68. Hung L.K., Pang K.W., Yeung P.L., et al. Active mobilisation after flexor tendon repair: comparison of results following injuries in zone 2 and other zones. J Orthop Surg (Hong Kong) 2005, 13:158-163.
69. Caulfield R.H., Maleki-Tabrizi A., Patel H., et al. Comparison of zones 1 to 4 flexor tendon repairs using absorbable and unabsorbable four-strand core sutures. J Hand Surg Eur 2008, 33:412-417.
70. Hoffmann G.L., Büchler U., Voeglin E. Clinical results of flexor tendon repair in zone II using a six-strand double-loop technique compared with a two-strand technique. J Hand Surg Eur 2008, 33:418-423.
71. Al-Qattan M.M., Al-Turaiki T.M. Flexor tendon repair in zone 2 using a six-strand 'figure of eight' suture. J Hand Surg Eur 2009, 34:322-328.
72. De Aguiar G., Chait L.A., Schultz D., et al. Chemoprotection of flexor tendon repairs using botulinum toxin. Plast Reconstr Surg 2009, 124:201-209.
73. Kitis P.T., Buker N., Kara I.G. Comparison of two methods of controlled mobilisation of repaired flexor tendons in zone 2. Scand J Plast Reconstr Surg Hand Surg 2009, 43:160-165.
74. Trumble T.E., Vedder N.B., Seiler J.G., et al. Zone-II flexor tendon repair: a randomized prospective trial of active place-and-hold therapy compared with passive motion therapy. J Bone Joint Surg Am 2010, 92:1381-1389.
75. Georgescu A.V., Matei I.R., Capota I.M., et al. Modified Brunelli pull-out technique in flexor tendon repair for zone II: a study on 58 cases. Hand (NY) 2011, 6:276-281.
76. Sandow M.J., McMahon M. Active mobilisation following single cross grasp four-strand flexor tenorrhaphy (Adelaide repair). J Hand Surg Eur 2011, 36:467-475.
77. Schaller P. Repair of the flexor pollicis longus tendon with the motion-stable Mantero technique. Scand J Plast Reconstr Surg Hand Surg 2010, 44:163-166.
78. McFarlane R.M., Lamon R., Jarvis G. Flexor tendon injuries within the finger. A study of the results of tendon suture and tendon graft. J Trauma 1968, 8:987-1003.
79. Elliot D. Treatment of rupture of primary flexor tendon repairs. Tendon surgery of the hand 2012, 214-218. Elsevier Saunders, Philadelphia. J.B. Tang, P.C. Amadio, J.C. Guimberteau (Eds.).
80. Wong J.K., Cerovac S., Ferguson M.W., et al. The cellular effect of a single interrupted suture on tendon. J Hand Surg Br 2006, 31:358-367.