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The use of pedicled flexor digitorum superficialis tendon as a tendon graft in the
second stage of flexor tendon reconstruction has the advantage of employing local
intrasynovial tendon graft and allowing early active range of motion. This method
of staged flexor tendon reconstruction was used in 47 patients between 1083 and 1993.
Thirty-three patients were evaluated 1 year or longer after the second stage of surgery.
The follow-up period averaged 3.7 years. Sixty-four percent of the injuries were in
zone II, and 30% were Boyes grade V in severity. Good to excellent results were achieved
in 64% of patients. Three patients needed graft tenolysis. Postoperative persistent
flexion contractures ranging from 8° to 55° of the proximal interphalangeal or distal
interphalangeal joints or both were present in 88% of patients. Several factors that
influenced the final outcome were identified: age over 25 years, zone II injuries
of Boyes grade V, and the lack of a regular postoperative rehabilitation program were
associated with relatively less successful final results.
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References
- Two-stage plasty in flexor tendon injuries of fingers within the digital synovial sheath.Acta Chir Plast. 1965; 7: 112-124
- Two-stage tenoplasty in injury of the flexor tendons of the hand.J Bone Joint Surg. 1969; 51A: 21-32
- Flexor tendon reconstruction in severely damaged hands: a two-stage procedure using a silicone-Dacron reinforced gliding prosthesis prior to tendon grafting.J Bone Joint Surg. 1971; 53A: 829-858
- Use of a pedicled tendon transfer with a silicone rod in complicated secondary flexor tendon repairs.J Plast Reconstr Surg. 1972; 49: 439-443
- Combined two-stage tenoplasty with silicone rods for multiple flexor tendon injuries in “no-man's land”.J Trauma. 1972; 12: 104-121
- Pedicle tendon graft for flexor tendon injuries of the fingers.J Bone Joint Surg. 1973; 55B: 881-882
- Staged reconstruction of flexor tendons with a silicone rod and a “pedicled” sublimis transfer.Plast Reconstr Surg. 1978; 61: 756-761
- Experience with a two-stage pedicled flexor tendon graft.Hand. 1979; 11: 198-205
- Two stage superficialis reconstruction in severely damaged fingers.J Hand Surg. 1980; 5: 135-143
- Two-stage tenoplasty: result.in: Hunter JM Schneider LH Mackin EJ Tendon surgery in the hand. CV Mosby, St. Louis1987: 272-281
- Staged flexor tendon reconstruction in the fingers and hand.J Hand Surg. 1988; 13A: 559-562
- Two-stage flexor-tendon reconstruction: ten-year experience.J Bone Joint Surg. 1986; 68A: 752-763
- Flexor tendon grafts in the fingers and thumb: an evaluation of end results.J Bone Joint Surg. 1950; 32A: 489-499
- Flexor tendon grafts in the fingers and thumb: a study of factors influencing results in 1000 cases.J Bone Joint Surg. 1971; 53A: 1332-1342
- The zig-zag volar-digital incision for flexor tendon surgery.J Plast Reconstr Surg. 1967; 40: 571-574
- Primary flexor tendon repair followed by immediate controlled mobilization.J Hand Surg. 1977; 2: 441-451
- Management of flexor tendon lacerations in zone 2 using controlled passive motion postoperatively.in: Hunter JM Schneider LH Mackin E Bell J Rehabilitation of the hand. CV Mosby, St. Louis1978: 219-224
- Staged flexor tendon reconstruction using the method of Hunter.Clin Orthop. 1982; 171: 164-171
- An evaluation of the two-stage flexor tendon reconstruction technique.J Hand Surg. 1983; 8: 263-267
- 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
- Experimental flexor tendon healing without adhesion formation: a new concept of tendon nutrition and intrinsic healing mechanisms. A preliminary report.Hand. 1976; 8: 235-238
- Experimental intrinsic healing of flexor tendons based upon synovial fluid nutrition.J Hand Surg. 1978; 3: 21-31
- Intercalary flexor tendon grafts: a morphological study of intrasynovial and extrasynovial donor tendons.Scandinavian J Plast Reconstr Surg Hand Surg. 1992; 26: 257-264
- Flexor tendon healing and restoration of the gliding surface: an ultrastructural study in dogs.J Bone Joint Surg. 1983; 65A: 70-80
- Autogenous flexor tendon grafts: a biomechanical and morphological study in dogs.J Bone Joint Surg. 1993; 75A: 1004-1014
- Staged tendon reconstruction.Hand Clin. 1985; 1: 109-120
Article info
Publication history
Accepted:
August 15,
1996
Received:
August 25,
1995
Footnotes
*No benefits in any form have been received or will be received from a commerical party related directly or indirectly to the subject of this article.
Identification
Copyright
© 1997 The American Society for Surgery of the Hand. All rights reserved. Published by Elsevier Inc.