title: Functional outcome of the hand following flexor tendon repair at the 'no man's land'.
abstract: OBJECTIVE
  To evaluate the functional outcome of the hand following flexor tendon repair at 'no man's land' using 2 strands of a modified Kessler core suture and combined controlled motion rehabilitation protocol.
  
  
  METHODS
  Records of 31 zone-2 flexor tendon injuries in 21 digits of 16 patients between July 2000 and June 2005 were reviewed retrospectively. The injured tendons were repaired within 24 hours using 2 strands of a modified Kessler core suture, reinforced by a continuous circumferential epitendon suture. All patients completed a rehabilitation protocol that included active extension against a rubber band, passive flexion, and controlled passive extension and passive flexion exercises. Functional outcome of the fingers was assessed using the Buck-Gramcko II score. Hand grip strength, rehabilitation period, and rupture rate were also measured.
  
  
  RESULTS
  17 (81%) out of 21 digits in 15 out of 16 patients achieved an excellent-to-good functional grade. The remaining patient with concomitant injuries to 4 (19%) digits attained a poor functional grade, attributable to poor compliance with the rehabilitation protocol. The mean rehabilitation period was 130 days and the mean grip strength was 78% that of the uninjured side. Concomitant digital nerve injury did not adversely affect the final outcome. Only one (4.8%) patient experienced a rupture.
  
  
  CONCLUSIONS
  The surgical method and rehabilitation protocol used for zone-2 flexor tendon injury is safe and results in a reasonably good functional outcome.
authors.affiliation: Department of Orthopaedics and Traumatology, Tseung Kwan O Hospital, Hang Hau, Hong Kong. chantunkut@yahoo.com.hk
authors.forename: T K
authors.initials: TK
authors.lastname: Chan
authors.forename: C O
authors.initials: CO
authors.lastname: Ho
authors.forename: W K
authors.initials: WK
authors.lastname: Lee
authors.forename: Y K
authors.initials: YK
authors.lastname: Fung
authors.forename: Y F
authors.initials: YF
authors.lastname: Law
authors.forename: C Y
authors.initials: CY
authors.lastname: Tsang
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005384:Finger Joint / Q000503:physiopathology; D005385:Fingers / Q000601:surgery*; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D016059:Range of Motion, Articular; D020127:Recovery of Function; D013536:Suture Techniques; D013710:Tendons / Q000601:surgery*; D016896:Treatment Outcome