title: Early ultrasound therapy for rehabilitation after zone II flexor tendon repair.
abstract: BACKGROUND
  In our Institute, most of the patients treated for hand injuries were industrial workers with poor compliance. For rehabilitation after zone II flexor tendon repair, we had tried various early mobilization protocols. As these protocols demanded a degree of commitment from the patients, our results were suboptimal. Hence, to improve the results, we implemented a new rehabilitation protocol by administering the pulsed ultrasound therapy during the early phase of tendon healing.
  
  
  METHODS
  This is a prospective study done over a period of five years from January 2008 to January 2013. A total of 100 patients and 139 digits with zone II flexor tendon injuries were studied. After randomization, we administered pulsed ultrasound therapy of different frequencies and intensities for a total of 72 patients and 99 digits and formulated three groups. The results of ultrasound treated cases were compared with each other and with the results of cases treated by immobilization protocol. The results were analyzed using 'Original Strickland' criteria.
  
  
  RESULTS
  72% excellent-good results in ultrasound (Group 1) protocol, 75% excellent-good results in ultrasound (Group 2) protocol, and 77% excellent-good results in ultrasound (Group 3) protocol were achieved. There was no case of rupture in the first two groups. The rupture rate was 7% in ultrasound (Group 3) protocol. Only 25% excellent-good results were obtained in the immobilization protocol.
  
  
  CONCLUSIONS
  After zone II flexor tendon repair, pulsed ultrasound therapy during the early rehabilitation phase is safe and effective. The results are comparable to early mobilization protocols.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Research and Rehabilitation of Hand, Govt. Stanley Hospital, Chennai, Tamil Nadu, India.
authors.forename: Krishnamurthy
authors.initials: K
authors.lastname: Geetha
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Research and Rehabilitation of Hand, Govt. Stanley Hospital, Chennai, Tamil Nadu, India.
authors.forename: Narayanan Chandramouli
authors.initials: NC
authors.lastname: Hariharan
authors.affiliation: Department of Plastic and Reconstructive Surgery, Institute for Research and Rehabilitation of Hand, Govt. Stanley Hospital, Chennai, Tamil Nadu, India.
authors.forename: Jagannathan
authors.initials: J
authors.lastname: Mohan
keywords: Early ultrasound therapy; PIP Joint flexion contracture; zone II flexor tendon repair