Rehabilitation of Flexor Tendons in Zone II: What Aspects Should We Take into Account When Assisting These Patients? Literature Review

DOI: https://doi.org/10.15417/issn.1852-7434.2021.86.5.1346
Keywords: Flexor tendons., rehabilitation, hand therapist, protocols, early active motion

Abstract

The treatment of flexor tendons is a topic of interest and creates a constant challenge for both surgeons and rehabilitators. Numerous surgical techniques and treatments have been described in order to improve functional results, although nowadays there is no ideal protocol. The objective of this article is to analyze the relevant information in order to plan the rehabilitation of patients with flexor tendon injuries in zone II. Among other aspects, we will take into account the strenght of the suture, the edema, the scar, the type of immobilization and the tendon gliding. Good teamwork is required between the surgeon, the hand therapist, and the patient in order to plan the most appropriate rehabilitation for each case.

Downloads

Download data is not yet available.

Author Biography

Jimena Ortiz, Gamma, Clínica de la Mano, Hombro y Codo, Sanatorio Ipensa, La Plata, Buenos Aires, Argentina
Gamma, Clínica de la Mano, Hombro y Codo, Sanatorio Ipensa, La Plata, Buenos Aires, Argentina

References

Wu YF, Tang JB. Tendon healing, edema, and resistance to flexor tendon gliding: clinical implications. Hand Clin

;29(2):167-78. https://doi.org/10.1016/j.hcl.2013.02.002

Amadio PC. Friction of the gliding surface: implications for tendon surgery and rehabilitation. J Hand Ther

;18(2):112-9. https://doi.org/10.1197/j.jht.2005.02.005

Evans RB. Managing the injured tendon: current concepts. J Hand Ther 2012;25(2):173-89.

https://doi.org/10.1016/j.jht.2011.10.004

Hsiao PC, Yang SY, Ho CH, Chou W, Lu RL. The benefit of early rehabilitation following tendon repair of the hand: a population-based claims database analysis. J Hand Ther 2015;28(1):20-5. https://doi.org/10.1016/j.jht.2014.09.005

Tang JB. Flexor tendon injuries. Clin Plast Surg 2019;46(3):295-306. https://doi.org/10.1016/j.cps.2019.02.003

Skirven T, Osterman A, Fedorczyk J, Amadio P, Feldscher S, Shin E. Therapy techniques. En: Rehabilitation of the

hand and upper extremity. 7th ed. Philadelphia: Elsevier; 2020:1393-478.

Colditz J. Regaining flexor tendon glide within zone 2. HandLab 2016;40:1-2. Disponible en:

https://bracelab.com/clinicians-classroom/regaining-flexor-tendon-glide-within-zone-2

Giesen T, Reissner L, Besmens I, Politikou O, Calcagni M. Flexor tendon repair in the hand with the M-Tang

technique (without peripheral sutures), pulley division, and early active motion. J Hand Surg Eur 2018;43(5):474-9.

https://doi.org/10.1177/1753193418758269

Athlani L, Detammaecker R, Touillet A, Dautel G, Foisneau A. Effect of different positions of splinting on flexor

tendon relaxation: a cadaver study. J Hand Surg Eur 2019;44(8):833-7. https://doi.org/10.1177/1753193419865123

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(3):261-8. https://doi.org/10.1016/0266-7681(88)90082-4

Peck FH, Roe AH, Ng CY, Duff C, McGrouther DA, Lees VC. The Manchester short splint: a change to splinting

practice in the rehabilitation of zone II flexor tendon repairs. J Hand Ther 2014;19(2):47-53.

https://doi.org/10.1177/1758998314533306

Woythal L, Holmer P, Brorson S. Splints, with or without wrist immobilization, following surgical repair of flexor tendon lesions of the hand: a systematic review. Hand Surg Rehabil 2019;38(4):217-22.

https://doi.org/10.1016/j.hansur.2019.05.004

Klifto CS, Bookman J, Paksima N. Postsurgical rehabilitation of flexor tendon injuries. J Hand Surg Am

;44(8):680-6. https://doi.org/10.1016/j.jhsa.2019.02.010

Venkatramani H, Varadharajan, Bhardwaj P, Vallurupalli A, Sabapathy R. Flexor tendon injuries. J Clin Orthop

Trauma 2019;10(5):853-61. https://doi.org/10.1016/j.jcot.2019.08.005

Chang M, Lim Z, Wong Y, Tay S. A review of cyclic testing protocols for flexor tendon repairs. Clin Biomech

;62:42-9. https://doi.org/10.1016/j.clinbiomech.2018.12.007

Vucekovich K, Gallardo G, Fiala K. Rehabilitation after flexor tendon repair, reconstruction, and tenolysis. Hand Clin 2005;21(2):257-65. https://doi.org/10.1016/j.hcl.2004.11.006

Strickland JW, Schmidt CC. Repair of flexor digitorum profundus lacerations: The Indiana method. Op Tech Orthop 1998;8(2):73-80. https://doi.org/10.1016/S1048-6666(98)80004-9

Higgins A, Lalonde D. Flexor tendon repair postoperative rehabilitation: the Saint John Protocol. Plast Reconstr Surg Global Open 2016;4(11):e1134. https://doi.org/10.1097/GOX.0000000000001134

Tang JB, Zhou X, Pan Z, Qing J, Gong K, Chen J. Strong digital flexor tendon repair, extension-flexion test, and

early active flexion: experience in 300 tendons. Hand Clin 2017;33(3):455-63.

https://doi.org/10.1016/j.hcl.2017.04.012

Tang JB, Amadio P, Guimberteau JC, Chang J. Clinical primary flexor tendon repair and rehabilitation. En: Tendon surgery of the hand. Philadelphia: Elsevier; 2012:116-8.

Giesen T, Calcagni M, Elliot D. Primary flexor tendon repair with early active motion: experience in Europe. Hand Clin 2017;33(3):465-72. https://doi.org/10.1016/j.hcl.2017.03.001

Colditz J. Protecting flexor tendon repairs. HandLab 2017;43:1-2. Disponible en:

https://bracelab.com/clinicians-classroom/protecting-flexor-tendon-repairs

Morrell NT, Hulvey A, Elsinger J, Zhang G, Shafritz AB. Team approach: repair and rehabilitation following flexor tendon lacerations. J Bone Joint Surg Rev 2017;5(1):1-7. https://doi.org/10.2106/JBJS.RVW.16.00013

Colditz J. Protective action of the lumbrical muscle to a healing flexor tendon repair during active finger extension. HandLab 2015;36:1-2. Disponible en: https://bracelab.com/media/magefan_blog/New/CP36-Lumbrical-Muscle-Healing-Flexor-Tendon-Repair-During-Active-Finger-Extension.pdf

Groth GN. Pyramid of progressive force exercises to the injured flexor tendon. J Hand Ther 2004;17(1):31-42.

https://doi.org/10.1197/j.jht.2003.10.005

Published
2021-10-10
How to Cite
Ortiz, J. (2021). Rehabilitation of Flexor Tendons in Zone II: What Aspects Should We Take into Account When Assisting These Patients? Literature Review. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(5), 696-704. https://doi.org/10.15417/issn.1852-7434.2021.86.5.1346
Issue
Vol 86 No 5 (2021): AACM
Section
Rehabilitación
Copyright (c) 2021 Revista de la Asociación Argentina de Ortopedia y Traumatología

Manuscript acceptance by the Journal implies the simultaneous non-submission to any other journal or publishing house. The RAAOT is under the Licencia Creative Commnos Atribución-NoComercial-Compartir Obras Derivadas Igual 4.0 Internacional (CC-BY-NC.SA 4.0) (http://creativecommons.org/licences/by-nc-sa/4.0/deed.es). Articles can be shared, copied, distributed, modified, altered, transformed into a derivative work, executed and publicly communicated, provided a) the authors and the original publication (Journal, Publisher and URL) are mentioned, b) they are not used for commercial purposes, c) the same terms of the license are maintained.

In the event that the manuscript is approved for its next publication, the authors retain the copyright and will assign to the journal the rights of publication, edition, reproduction, distribution, exhibition and communication at a national and international level in the different databases. data, repositories and portals.

It is hereby stated that the mentioned manuscript has not been published and that it is not being printed in any other national or foreign journal.

The authors hereby accept the necessary modifications, suggested by the reviewers, in order to adapt the manuscript to the style and publication rules of this Journal.