[Acute flexor tendon surgery].
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.
Stephan
Christine
C
Klinik für Handchirurgie Herz- und Gefässklinik, Salzburger Leite 1, Bad Neustadt/Saale. c.stephan@handchirurgie.de
Saalabian
Ali
A
van Schoonhoven
Jörg
J
Prommersberger
Karl-Josef
KJ
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