Abstract
Over a 5-year-period 15 patients with zone II partial flexor tendon lacerations that
were larger than half the width of the tendon were treated conservatively without
tendon suturing. Surgical exploration was done with a digital block and the flexor
tendons were observed as the patient fully extended and flexed the finger. If present,
the cause of triggering was determined and eliminated by trimming any beveled tendon
edge, resection of the involved pulleys, and repair of the flexor sheath. Early protected
mobilization was started the first day after injury using a dorsal splint. At 4 weeks
after injury the splint was removed and exercises against resistance were started.
None of the patients had triggering or rupture of the flexor tendons. Using the Strickland-Glogovac
evaluation method, results were excellent in 93% of cases and good in the remaining
7%. It was concluded that conservative management of zone II partial flexor tendon
lacerations larger than half the width of the tendon is safe as long as certain guidelines
regarding the prevention of triggering and protected mobilization are applied. (J
Hand Surg 2000;25A:1118-1121. Copyright © 2000 by the American Society for Surgery
of the Hand.)
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Hand SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Effects of suture on tensile strength gain of partially and completely severed tendons.Surg Forum. 1975; 26: 63-64
- Should an incompletely severed tendon sutured?.Plast Reconstr Surg. 1976; 57: 36-38
- Treatment of partial flexor tendon lacerations: the effects of tenorrhaphy and early protected mobilization.J Trauma. 1986; 26: 301-312
- Effects of tenorraphy on the gliding function and tensile properties of partially lacerated canine digital flexor tendons.J Hand Surg. 1999; 24A: 302-309
- An experimental study on incompletely cut chicken tendons—a comparison of two methods of management.J Hand Surg. 1984; 9B: 121-125
- Complications in flexor tendon injuries.in: Complications in hand surgery. WB Saunders, Philadelphia1986: 19-28
- Should an incompletely severed tendon be sutured? Commentary.Plast Reconstr Surg. 1976; 57: 236
- Clinical treatment of partial tendon lacerations without suturing and with early motion.Plast Reconstr Surg. 1977; 59: 231-234
- Treatment of partial tendon lacerations.Hand. 1980; 12: 163-166
- Partial flexor tendon injuries: to repair or not.J Hand Surg. 1992; 17B: 176-177
- Conservative management of transverse partial flexor digitorum profundus tendon lacerations in zone 2.Can J Plast Surg. 1995; 3: 157-160
- Partial lacerations of flexor tendons in children: primary repair versus conservative treatment.J Hand Surg. 1997; 22B: 377-380
- Clinical management of partially lacerated digital flexor tendons: a survey of hand surgeons.J Hand Surg. 1995; 20A: 273-275
- Digital function following flexor tendon repair in zone II: a comparison of immobilization and controlled passive motion techniques.J Hand Surg. 1980; 5: 537-543
- Triggering of the finger caused by flexor-tendon laceration: report of two cases.J Bone Joint Surg. 1976; 58A: 1174-1175
- Trigger finger following partial flexor tendon laceration.Hand. 1977; 9: 232-233
- Three complications of untreated partial laceration of flexor tendon—entrapment, rupture, and triggering.J Hand Surg. 1981; 6: 392-398
- Late rupture of one slip on the flexor digitorum superficialis: an unusual cause of triggering.Clin Orthop. 1981; 158: 142-143
- Trigger wrist caused by a partial laceration of the flexor superficialis tendon of the ring finger.J Hand Surg. 1986; 11B: 457-459
- Triggering secondary to an untreated partially-cut flexor tendon.J Hand Surg. 1989; 14B: 419-421
- Triggering after partial tendon laceration.J Hand Surg. 1993; 18B: 241-246
- Triggering of the finger secondary to partial flexor tendon tear after closed direct injury.J Hand Surg. 1993; 18A: 881-882
- Effect of motion and tension on injured flexor tendons in chickens.J Hand Surg. 1996; 21A: 456-463
- Partial lacerations of human digital flexor tendons: a biomechanical analysis.J Hand Surg. 1997; 22A: 1011-1015
- Three complications of untreated partial laceration of flexor tendon—entrapment, rupture, and triggering. Invited comment.J Hand Surg. 1981; 6: 396-398
Article info
Publication history
Accepted:
June 20,
2000
Received:
October 21,
1999
Footnotes
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**Reprint requests: Mohammed M. Al-Qattan. FRCSC. PO Box 18097, Riyadh 11415, Saudi Arabia.
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
