Early Active Motion Protocol following Triple Kessler Repair for Flexor Tendon Injury

Abstract

Purpose. To evaluate outcome of 6-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation. Methods. 25 men and one woman (36 fingers) underwent 6-strand triple Kessler repair for flexor tendon injuries in zones 2 to 5, followed by early active motion rehabilitation. Rehabilitation was started at days 3 to 5. Patients were instructed to passively flex all the fingers with the uninjured hand and to actively retain this position for 10 seconds. Active extension within the confines of the splint was allowed. At the end of week 8, strength training was commenced until a satisfactory range of motion was regained. Outcome measures included total active motion, grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Complications such as infection and wound dehiscence were recorded. Results. The mean follow-up was 1.2 (range, 1–2) years. Outcome was excellent in 24 digits, good in 4, and poor in 8. The mean grip strength was 80% (range, 60–100%) of normal in dominant hands and 60% (range, 50–65%) of normal in non-dominant hands. The mean DASH score was 15 (range, 0–52). One patient had wound dehiscence and superficial infection. Conclusion. Six-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation yields satisfactory results.