title: Effect of synergistic wrist motion on adhesion formation after repair of partial flexor digitorum profundus tendon lacerations in a canine model in vivo.
abstract: BACKGROUND
  Therapy employing passive finger flexion and active finger extension with the wrist fixed in flexion is commonly used after flexor tendon repair. However, this method of rehabilitation may not produce full tendon excursion because of buckling of the tendon within its sheath with passive flexion. Studies of cadavera suggest that the use of synergistic wrist and finger motion may improve tendon gliding. The purpose of this study was to assess the effects of passive digital motion, performed with either wrist fixation or synergistic wrist motion, on adhesion and gap formation after flexor tendon repair.
  
  
  METHODS
  Sixty-six dogs were randomly allocated to two groups. In each group, two flexor digitorum profundus tendons of one forepaw were partially (80%) lacerated and then repaired with a modified Kessler suture. In each group, a different postoperative therapy (wrist fixation or synergistic motion) was performed twice daily. The dogs were killed at one week, three weeks, or six weeks after surgery, and the repaired tendons were evaluated to determine the adhesion grade and adhesion breaking strength.
  
  
  RESULTS
  The synergistic motion group had a significantly lower adhesion grade and significantly less adhesion breaking strength than the wrist fixation group at three and six weeks (p < 0.05). At one week, there was no significant difference between the two therapy groups (p > 0.05).
  
  
  CONCLUSIONS
  Passive digital flexion and extension with synergistic wrist motion was an effective therapy after repair of partial zone-2 lacerations in a canine model.
authors.affiliation: Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Chunfeng
authors.initials: C
authors.lastname: Zhao
authors.forename: Peter C
authors.initials: PC
authors.lastname: Amadio
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Momose
authors.forename: Paulus
authors.initials: P
authors.lastname: Couvreur
authors.forename: Mark E
authors.initials: ME
authors.lastname: Zobitz
authors.forename: Kai-Nan
authors.initials: KN
authors.lastname: An
mesh_terms: D000818:Animals; D004285:Dogs; D005385:Fingers; D013708:Tendon Injuries / Q000534:rehabilitation* / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control; D014953:Wrist / Q000502:physiology*