title: COMPARATIVE STUDY BETWEEN TRADITIONAL TENOLYSES AND WITH INTRAOPERATIVE AWAKENING PERFORMED ON THE FLEXOR OSTEOFIBROUS TUNNEL REGION OF THE HANDS (ZONE 2).
abstract: OBJECTIVE
  Flexor tendon tenolysis on zone 2 is a difficult and really challenging for hand surgery. With the objective of comparing the results obtained between tenolyses with intraoperative awakening, performed with locoregional anesthesia (group 1), from those obtained with traditional tenolysis performed under general anesthesia or total blockage of the brachial plexus (group 2), the authors conducted a prospective and controlled study.
  
  
  METHODS
  22 patients with 39 fingers with flexor tendon injuries on zone 2 evolving to adherences were assessed. All patients were operated after three months and before one year of the primary tendinous suture. All patients showed limited active motion not improved by rehabilitation. Groups 1 and 2 showed to be homogenous concerning patients' age and gender, preoperative compromising, and absence of associated injuries or pathologies. All patients were assessed according to active motion (TAMs) both preoperatively and at 6 months postoperatively.
  
  
  RESULTS
  The statistical analysis of data obtained for groups 1 and 2 shows that the tenolysis performed with both techniques produce good results. By comparing the results for total active motion after six months of the tenolysis, group 1 patients (treated by the intraoperative awakening technique) were found to present better outcomes.
  
  
  CONCLUSIONS
  Flexor tenolysis on zone 2 provide good results in terms of joint range of motion. The intraoperative awakening technique with locoregional anesthesia provides improved outcomes when compared to the traditional technique.
authors.affiliation: Third-year Resident, Department of Orthopedics, ABC School of Medicine.
authors.forename: Tiago Guedes da Motta
authors.initials: TG
authors.lastname: Mattar
authors.affiliation: Department of Orthopedics and Traumatology, FMUSP.
authors.forename: Rames Mattar
authors.initials: RM
authors.lastname: Junior
authors.affiliation: Department of Orthopedics, ABC School of Medicine and M.D. from the Department of Orthopedics and Traumatology, FMUSP.
authors.forename: Alvaro Baik
authors.initials: AB
authors.lastname: Cho
authors.affiliation: Department of Orthopedics and Traumatology, FMUSP.
authors.forename: Emygdio Jose Leomil de
authors.initials: EJ
authors.lastname: Paula
authors.affiliation: Department of Orthopedics and Traumatology, FMUSP.
authors.forename: Marcelo Rosa
authors.initials: MR
authors.lastname: Rezende
keywords: Finger injuries; Rehabilitation; Tendon injuries; Tendons/surgery