Technology of temporary isolation of the deep digital flexor tendon and management of patients in zone II delayed repair

Abstract

Introduction Healing of the digital flexor tendon following zone II delayed repair is associated with tenogenic contractures. Objective Develop and test a new technology of tendon repair in scarry fibro-osseous canals in clinic. Material and methods Medical reports and clinical findings of 11 patients with flexor tendon injures to 13 fingers occurred 4 to 6 weeks were reviewed. Two-stage tendon plasty was secured for the patients. With the possibility of suturing in scarry obliterated canal treatment was produced according to the technique developed. Split sterile bioinert polymeric tubes were used for temporary tendon isolation. Results An experience of delayed repair of 13 deep digital flexor tendons and temporary isolation with a split polymeric tube in zone II is reported. Motor rehabilitation of patients could be initiated after 3 postoperative days with the repaired tendon being unloaded with the tube. There was no tube reaction, tendon repair failures or other complications observed with the use of new technology. Discussion Polymeric tube can prevent adhesion in the tunnel, protect the repaired site during early motion stress. Conclusion The new technology can be an alternative to a two-stage flexor tendon reconstruction facilitating good function recovery and ability to return to work after 2.5−3.5 months.

Keywords

• tendon repair
• early motion stress
• tendon temporary isolation
• fibro-osseous canal