title: [Acute flexor tendon surgery].
abstract: OBJECTIVE
  Flexor tendon repair by direct suture, providing tendon function and mechanical properties and allowing postoperative active extension and flexion.
  
  
  METHODS
  Flexor tendon laceration in all zones, when primary healing and a good functional outcome can be expected.
  
  
  METHODS
  Florid and chronic infection. Lack of skill, instruments, or manpower. Tension-free suture is not feasible. Severe soft-tissue problems. Mantero suture in case of coexistent artery injury.
  
  
  METHODS
  Hand surgical incisions and approach to the tendon. Opening of the tendon sheath in the region of oblique pulley. A four-strand core suture consisting of two locked two-strand sutures and a circumferential epitendon cross-stitch suture are performed. Lacerations in zone I with a tendon stump shorter than 1 cm require a Mantero suture and avulsions require a pull-out suture technique.
  
  
  METHODS
  Active flexion and active extension in a dorsal wrist cast.
  
  
  RESULTS
  The clinical outcome studies after repair of zone II flexor tendon injuries using a multiple-strand suture technique describe 69-96% excellent and good results.
authors.affiliation: Klinik für Handchirurgie Herz- und Gefässklinik, Salzburger Leite 1, Bad Neustadt/Saale. c.stephan@handchirurgie.de
authors.forename: Christine
authors.initials: C
authors.lastname: Stephan
authors.forename: Ali
authors.initials: A
authors.lastname: Saalabian
authors.forename: Jörg
authors.initials: J
authors.lastname: van Schoonhoven
authors.forename: Karl-Josef
authors.initials: KJ
authors.lastname: Prommersberger
mesh_terms: D002370:Casts, Surgical; D005383:Finger Injuries / Q000601:surgery*; D006225:Hand / Q000601:surgery*; D006801:Humans; D022125:Lacerations / Q000601:surgery; D011182:Postoperative Care; D011300:Preoperative Care; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing