Early Active Motion Protocol following Triple Kessler Repair for Flexor Tendon Injury

• Published in: Journal of orthopaedic surgery (Hong Kong) Vol. 22; no. 1; pp. 96 - 99
• Main Authors: Rajappa, S, Menon, PG, Kumar, M Mohan, Raj, D Gokul
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2014; Sage Publications Ltd; SAGE Publishing
• Subjects: Adult; Female; Finger Injuries - physiopathology; Finger Injuries - rehabilitation; Finger Injuries - surgery; Fingers & toes; Follow-Up Studies; Humans; Infections; Injuries; Male; Range of Motion, Articular - physiology; Rehabilitation; Repair & maintenance; Tendon Injuries - physiopathology; Tendon Injuries - rehabilitation; Tendon Injuries - surgery; Tendon Transfer - methods; Time Factors; Treatment Outcome; Wound healing; treatment outcome; finger injuries
• ISSN: 1022-5536; 2309-4990
• DOI: 10.1177/230949901402200124

Purpose. To evaluate outcome of 6-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation. Methods. 25 men and one woman (36 fingers) underwent 6-strand triple Kessler repair for flexor tendon injuries in zones 2 to 5, followed by early active motion rehabilitation. Rehabilitation was started at days 3 to 5. Patients were instructed to passively flex all the fingers with the uninjured hand and to actively retain this position for 10 seconds. Active extension within the confines of the splint was allowed. At the end of week 8, strength training was commenced until a satisfactory range of motion was regained. Outcome measures included total active motion, grip strength, and the Disabilities of the Arm, Shoulder and Hand (DASH) score. Complications such as infection and wound dehiscence were recorded. Results. The mean follow-up was 1.2 (range, 1–2) years. Outcome was excellent in 24 digits, good in 4, and poor in 8. The mean grip strength was 80% (range, 60–100%) of normal in dominant hands and 60% (range, 50–65%) of normal in non-dominant hands. The mean DASH score was 15 (range, 0–52). One patient had wound dehiscence and superficial infection. Conclusion. Six-strand triple Kessler repair for flexor tendon injuries, followed by early active motion rehabilitation yields satisfactory results.