Clinical Outcomes of Two-stage Flexor Tendon Reconstruction in the Hand: Experience with Early Postoperative Combined Protocol of Controlled Motion.
10.4055/jkoa.2006.41.1.19
- Author:
Sang Jin CHEON
1
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Pusan National University, Busan, Korea. scheon@pusan.ac.kr
- Publication Type:Original Article
- Keywords:
Old flexor tendon injury;
Two-stage flexor tendon reconstruction;
Early postoperative combined protocol of controlled motion
- MeSH:
Cicatrix;
Classification;
Contracture;
Follow-Up Studies;
Hand*;
Humans;
Rehabilitation;
Rupture;
Tendon Injuries;
Tendons*
- From:The Journal of the Korean Orthopaedic Association
2006;41(1):19-27
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To analyze the final results of a two-stage flexor tendon reconstruction in the hand with the early postoperative combined protocol of controlled motion, and to identify the prognostic factors associated with the final results. MATERIALS AND METHODS: Nine cases of two-stage flexor tendon reconstructions in 9 patients, who had been unable to flex their digits due to old flexor tendon injury, were examined. Using the modified Boyes' injury severity classification, the digits were classified as grades 1, 2 and 3 in 1, 5 and 3 patients, respectively. The average follow-up period was 1 year and 8 months and the final results are expressed using the Buck-Gramcko assessment system. RESULTS: Eight out of nine hands were graded as excellent and one patient whose injury severity had been graded 3 was graded as good. Excellent results were found in patients with a more than 10-year interval between the injury and the stage I procedure. Of the 3 patients who had undergone contracture release two were excellent and one was good. All 5 patients with a pulley reconstruction had excellent results. Complications involved one infection at the distal incision site, one tendon rupture and four flexion contractures. CONCLUSION: A two-stage flexor tendon reconstruction with an early postoperative combined protocol of controlled motion is a useful procedure for restoring the flexor performance in old badly scarred digits. The excellent or good results might be due to following: the early protected rehabilitation incorporating two protocols, a pulley reconstruction and protection, flexion contracture release, an initial injury with less than moderate grade and the young age of the patients.
