REHABILITATION AND POSTOPERATIVE MANAGEMENT AFTER FLEXOR TENDON REPAIR | Issues of reconstructive and plastic surgery. 2018. № 2 (65). DOI: 10.17223/1814147/65/08

REHABILITATION AND POSTOPERATIVE MANAGEMENT AFTER FLEXOR TENDON REPAIR

The surveillance of patients after surgical flexor tendon repair is still an open question for many hand surgeons. There is no common protocol suitable for any case. The complex anatomy of palm tendons and high risk of adhesion in the early postoperative period often lead to unsatisfactory results of treatment. Unfortunately, the large number of bad results after tendon repair falls on incorrect postoperative management. This paper presents a review of modern methods and approaches to postoperative management and following rehabilitation of patients after flexor tendon repair. The paper presents a selection algorithm, which would be useful to practicing surgeons.

Download file

Counter downloads: 828

Keywords

сухожилия сгибателей кисти, реабилитация, послеоперационное ведение, сухожильная пластика, flexor tendon, rehabilitation, postoperative management, tendon plastic

Authors

Name	Organization	E-mail
Ovsyannikova A.D.	St. Petersburg State University, Clinics of High Medical Technologies	medovsyannikova@gmail.com

Всего: 1

References

Armenta E., Lehrman A. The vincula to the flexor tendons of the hand. J Hand Surg. 1980;5:127-134.

Розов В.И. Повреждения сухожилий кисти и пальцев. Л.: Медгиз, 1952:192 с.

Skirven T.M., Osterman A.L., Fedorczyk J., Amadio P.C. Rehabilitation of the Hand and Upper Extremity, 6th ed., 2-Vol. set. Elsevier Churchill Livingstone, 2010:2191 p.

Lundborg G., Holm S., Myrhage R. The role of the synovial fluid and tendon sheath for flexor tendon nutrition. An experimental tracer study on diffusional pathways in dogs. Scand J Plast Reconstr Surg. 1980;14:99-107.

Lundborg G., Rank F. Experimental studies on cellular mechanisms involved in healing of animal and human flexor tendon in synovial environment. Hand. 1980;12:3-11.

Strickland J.W. Flexor tendon injuries. In: Master techniques in orthopedic surgery, the hand, 2nd ed. Strickland J.W., Graham T.J. eds. Lippincott Williams & Wilkins, Philadelphia, 2005:251-265.

Manske P.R., Lesker P.A. Flexor tendon nutrition. Hand Clin. 1985;1:13-24.

Lundborg G., Rand F. Experimental intrinsic healing of flexor tendons based upon synovial fluid nutrition. J Hand Surg. 1978;3:21-31.

Garner W.L., McDonald J.A., Kuhn C. III, Week P.M. Autonomous healing of chicken flexor tendons in vitro. J Hand Surg. 1988;13A:697-700.

Gelberman R.H., Steinberg D., Amiel D., Akeson W. Fibroblast chemotaxis after tendon repair. J Hand Surg. 1991;16A:686-693.

Gelberman R.H., Vandeberg J.S., Manske P.R., Akeson W.H. The early stages of flexor tendon healing: a morphologic study of the first fourteen days. J Hand Surg. 1985;10A: 776-784.

Manske P.R., Lesker P.A. Histologic evidence of intrinsic flexor tendon repair in various experimental animals. An in vitro study. Clin Orthop. 1984;182:297-304.

Umeda H.T. An experimental study on the intrinsic healing mechanism of digital flexor tendons. J Jpn Orthop Assoc. 1978;52:917-929.

Gelberman R.H., Khabie V., Cahill C.J. The revascularization of healing flexor tendons in digital sheath: A vascular injection study in dogs. J Bone Joint Surg. 1991;73A:868-881.

Kubota H., Manske P.R., Aoki M., Pruitt D.L., Larson B.J. Effect of motion and tension on injured flexor tendons in chickens. J Hand Surg. 1996;21A:456-463.

Halikis M.N., Manske P.R., Kubota H., Aoki M. Effect of immobilization, immediate mobilization, and delayed mobilization on the resistance to digital flexion using a tendon injury model. J Hand Surg. 1997;22A:464-472.

Strickland J.W. Development of Flexor Tendon Surgery: Twenty-Five Years of Progress. J Hand Surg. 2000;25A(2):214-235.

Starr H.M., Snoddy M., Hammond K.E., Seiler J.G. 3rd. Flexor tendon repair rehabilitation protocols: a syste-matic review. J Hand Surg Am. 2013 Sep;38(9):1712-7.e1-14. doi: 10.1016/j.jhsa.2013.06.025.

Обросов А.Н., Карачевцева Т.В., Ясногорский В.Г. и др. Руководство по физиотерапии и физиопрофилактике детских заболеваний. 3-e изд. M.: Медицина, 1987:42 c.

Freivalds A. Biomechanics of the upper limbs: mechanics, modeling, and musculoskeletal injuries, CRC Press LLC, Florida. 2004:625 p.

Kleinert H.E., Schepels S., Gill T. Flexor tendon injuries. Surg Clin North Am. 1981;61:267-286.

Duran R.J., Houser R.G., Coleman C.R., Stover M.G. Management of flexor tendon lacerations in zone 2 using controlled passive motion postoperatively. In: Hunter J.M., Schneider L.H., Mackin E.J., eds. Tendon surgery in the hand. St Louis: CV Mosby, 1978:178-182.

Knight S.L. A modification of the Kleinert splint for mobilisation of digital flexor tendons. J Hand Surg. 1987; 12B:179-181.

Cannon N.M. Post flexor tendon repair motion protocol. The Indiana Hand Center Newsletter. 1993;1:13-17.

Su F.C., Chou Y.L., Yang C.S., Lin G.T., An K.N. Movement of finger joints induced by synergistic wrist motion. J Clin Biomech. 2005 Jun;20(5):491-7.

Zhao C., Amadio P.C., Momose T., Couvreur P., Zobitz M.E., An K.N. Effect of synergistic wrist motion on adhesion formation after repair of partial flexor digitorum profundus tendon lacerations in a canine model in vivo. J Bone Joint Surg Am. 2002 Jan;84-A(1):78-84.

Evans R.B. Early active motion following flexor tendon repair. In: Berger R.A., Weiss A.P., editors. Hand surgery. Philadelphia: Lippincott and Williams; 2003.

Vucekovich K., Gallardo G., Fiala K. Rehabilitation after flexor tendon repair, reconstruction, and tenolysis. Hand Clin. 2005 May;21(2):257-65.

Higgins A., Lalonde D. Flexor Tendon Repair Postoperative Rehabilitation: The Saint John Protocol. Plast Reconstr Surg Glob Open. 2016;4:e1134; doi: 10.1097/GOX.0000000000001134.

Kannas S., Jeardeau T.A., Bishop A.T. Rehabilitation following zone II flexor tendon repairs. Tech Hand Up Extrem Surg. 2015 Mar;19(1):2-10. doi: 10.1097/BTH.0000000000000076.

Gratton P. Early active mobilization after flexor tendon repairs. J Hand Ther. 1993 Oct-Dec;6(4):285-289.

Evans R.B., Thompson D.E. The application of force to the healing tendon. J Hand Ther. 1993;6:266-284.

Su F.C., Chou Y.L., Yang C.S., Lin G.T., An K.N. Movement of finger joints induced by synergistic wrist motion. Clin Biomech (Bristol, Avon). 2005 Jun;20(5):491-7.

Howell J.W., Peck F. Rehabilitation of flexor and extensor tendon injuries in the hand: current updates. Injury. 2013;44:397-402.