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At least 91 records · Page 5Linked to original sources
PubMed1997

Effect of immobilization, immediate mobilization, and delayed mobilization on the resistance to digital flexion using a tendon injury model.

This study employed a tendon injury model in chickens to determine the effect of immobilization, immediate mobilization, and delayed mobilization on the energy required to fully flex the digit following surgical trauma to the tendon, as determined by measurement of the work of flexion (WOF). The immobilized group showed no increased WOF at 3 days compared to the zero time control values, followed by significant increased WOF at 1 week (36%), 2 weeks (41%), and 3 weeks (63%). The immediate mobilization tendons showed an initial 36% rise in the work of flexion at 3 days, which increased to 40% at 1 week, and then decreased to baseline control values by 3 weeks. Delaying the period of mobilization until 5 days was not shown to significantly lower the peak WOF value at 1 week, but delaying the period of mobilization until 3 days lowered the peak WOF value at 1 week dramatically to 13%; both the 3- and 5-day delayed-mobilization groups returned to baseline WOF values by 3 weeks. From these data, it can be assumed that there is an early increase in the work necessary for flexion of the injured operated digit and tendon that is present in the immediately mobilized tendons at 3 days and persists to 1 week and that does not appear until 1 week in the immobilized tendons; this rise in WOF can be blunted by delaying the institution of mobilization.

Animals↗
PubMed1981

[Preoperative prognostic assessment of flexor tendon injuries in the no man's land (author's transl)].

A preoperative prognostic grouping has been worked out for flexor tendon injuries in the no man's land, based on the works of Boyes and Buck-Gramcko. Prognosis of the secondary reconstructive procedures is influenced mostly by the age of the patient, the time elapse from the injury and the type, severity and combination of the hand injury (the so called preoperative state) as it was found in own experiences as well as in the literature. Bearing these aspects in mind, a classification has been worked out, with excellent, good, fair and bad preoperative prognostic values in the flexor tendon injuries, This classification makes the correlation and evaluation of the results more precise in those departments, where the care of the patients requiring hand surgery is performed according to the modern standards. With this grading of prognosis, a more adequate operation can be selected, according to the severity of tendon injury, with better results.

Age Factors↗
PubMed2002

Splinting programmes for tendon injuries.

It is beyond doubt that splinting programmes have often been an integral and important part of the rehabilitation process in tendon injuries. Over the past three decades, hand splints for tendon injuries of various designs and different mobilisation programmes have been developed in the hope of pursuing better clinical and functional outcome for patients. In this paper, the development of different splinting programmes in flexor and extensor tendon injuries and the current practice in some acute hospitals in Hong Kong were discussed.

Delivery of Health Care↗
PubMed1985

Tendon injuries--extensor surface.

Although discussed much less than flexor tendon injuries, achievement of satisfactory function is difficult with these injuries. Under proper circumstances in clean wounds, and in a well equipped emergency department, they can be primarily repaired if the examining physician has the experience. If these conditions are not possible, the patient should be referred to a qualified hand surgeon. The author outlines treatment according to anatomic zones.

Emergencies↗
PubMed1976

Repair of extensor tendon injuries of the hand.

We have presented methods for treating extensor tendon injuries from the interphalangeal joint to the wrist and the musculotendinous junction in the forearm. Early and proper splinting in the treatment of extensor tendon injuries is more important than a specific method of surgical repair. We emphasize the need for prolonged splinting, up to eight weeks in distal injuries. Immobilizing the finger in full extension or hyperextension is necessary at the distal and proximal interphalangeal joints. Correct splinting is mandatory in any method of treatment. Reconstruction of the extensor mechanism is difficult and the results are unpredictable.

Finger Injuries↗
PubMed1991

[The most frequent tendon injury: the "mallet finger". Review, therapeutic concept and results].

This study covers treatment and after-treatment of 126 extensor tendon injuries of the DIP-joint in 125 patients over a period of 4 years. Tendon injuries were classified into 4 types and the final results were evaluated using a modified Riedeberger and Zeumer scale. In recent subcutaneous tendon injuries conservative therapy is indicated, depending on the primary extension deficit (less than 20 degrees modified Stack splint, greater than 20 degrees Mommsen plaster of Paris or special dressing). Chip fractures should be stabilized by pull-out suture.

Athletic Injuries↗
PubMed2000

[Repair of flexor-tendon injury in children's finger using microsurgical technique].

OBJECTIVE: To improve the clinical result of repair on flexor tendon injury, and recover the defected finger function in children as far as possible. METHODS: From January 1990 to October 1997, 12 cases with flexor tendon injury were repaired by microsurgical technique, sutured by modified Kessler method with 3/0 or 5/0 nontraumatic thread and followed by invering suture of the gap edge with 7/0 or 8/0 nontraumatic thread after debridement. Appropriate functional practice was performed postoperatively. RESULTS: All the defected fingers were healed by first intention. Followed up 6 months to 1 year, there was excellent in 7 cases, better in 4 cases, moderate in 1 case and 91.67% in excellent rate according to the TAM standard of International Hand Committee. CONCLUSION: The important measures to improve the clinical result in children's flexor tendon injury are prompt and accurate diagnosis and repair of the injured tendon by microsurgical technique, and effective postoperative functional practice.

Child↗
PubMed2004

[Long-term results of early primary repair of flexor pollicis longus tendon injuries].

OBJECTIVES: We evaluated the long-term results of early primary repair of flexor pollicis longus (FPL) tendon injuries with the modified Kessler method and circumferential sutures. METHODS: Thirty patients (10 females, 20 males; mean age 26 years; range 4 to 52 years) were treated primarily with end-to-end anastomosis for FPL tendon injuries at the level of zone I to IV. Injuries were in the left thumb in 16 patients and in the right thumb in 14 patients. They were localized in zone I in one patient, zone II in 15 patients, zone III in nine patients, and zone IV in five patents. Twenty-five patients were treated within the first few hours after injury, while five patients were treated within a period ranging from 1 to 34 days. Associated digital artery and nerve injuries in 23 patients were treated during the same session. A rehabilitation program was implemented according to the modified Duran method. Functional evaluations were made according to the Buck-Gramcko system. The mean follow-up was 34 months (range 5 to 71 months). RESULTS: Functional results were excellent in 17 patients (56.6%), good in five patients (16.6%), fair in five patients (16.6%), and poor in three patients (9.9%). Excellent and good results accounted for 73.3% and 88.8% in zone II and zone III injuries, respectively. No significant differences existed between functional results obtained from patients with and without associated neurovascular injuries. CONCLUSION: Early primary end-to-end repair followed by an appropriate rehabilitation program yields very good functional results in patients with FPL tendon injuries, whether or not they are associated with neurovascular injuries.

Adolescent↗
PubMed1976

Gliding function following flexor-tendon injury. A biomechanical study of rat tendon function.

Gliding function of flexor tendons one hour to eight weeks after a standard injury was studied in rat digits by determining terminal force of flexion, tendon excursion, and work of flexion using a tensile testing machine. A rapid decrease in gliding occurred within hours of injury, indicating that the postoperative hematoma and edema restrict gliding long before collagenous adhesions are synthesized. The improvement in gliding function with time implies that fibrous adhesions can be remodeled. Surgical methods and therapeutic agents, therefore, should be directed toward limiting early tissue injury and seeking ways to enhance the late remodeling of fibrous peritendinous adhesions along functional lines.

Animals↗
PubMed2001

Peroneal tendon injuries. Report of thirty-eight operated cases.

BACKGROUND AND AIMS: Peroneal tendon injuries are probably frequently overlooked causes of lateral ankle pain after distorsion trauma. We report a series of 38 patients with peroneal tendon injuries and outcome after operation. MATERIAL AND METHODS: The mean age of the patients was 30 years (range, 13 to 61). All patients were operated by the same orthopaedic surgeon (SO) and the final outcome was evaluated. RESULTS: Eighty-two per cent of the patients were competitive athletes. There were 11 partial and 3 total ruptures of the peroneus brevis tendon (PBT), 2 partial and 2 total ruptures of the peroneus longus tendon (PLT). Nine cases of subluxations or luxations were treated. There were also 5 cases of chronic peroneal tendinitis or tenosynovitis, 5 cases of peroneal tendon anomalies and 1 ganglion. The peroneal tendon lesion was associated to ankle instability in 19 cases (50%). In ninety percent of the cases the result of the operation was excellent or good. CONCLUSIONS: The lateral ligaments are usually damaged in ankle distorsion injuries, but peroneal tendon lesions are often overlooked and probably more common cause of persistent lateral ankle pain than previously thought. Ruptures and luxations of the peroneal tendons need operative treatment in most cases.

Adolescent↗
PubMed2005

Delayed treatment of flexor tendon injuries including grafting.

This article synthesizes an enormous amount of peer reviewed articles, book chapters, and anecdotal clinical information regarding the late management of flexor tendon injuries by free-tendon grafting, tenolysis, and staged reconstruction. Some of the most pertinent historical contributions to these subjects have been reviewed in concert with an update regarding the most widely used current clinical methods for performing these procedures. This article points out areas of controversy and references the dissenting opinions from those presented here. The delayed treatment of flexor tendon injuries has advanced considerably in the last half century. Although much of the sage advice of the historic masters of flexor tendon surgery remains clinically applicable today, newer techniques and much improved therapy protocols have improved appreciably the results of the procedures described in this treatise. It is realistic and exciting to anticipate that the future will continue to improve the results of these methods through biologic manipulation of tendon healing and adhesion formation.

Finger Injuries↗
PubMed2003

[Treatment of flexor tendon injuries in children].

In contrast to the standard therapy of flexor tendon injuries in adults, the postoperative treatment program for children remains a controversial topic. Some prefer immobilization therapy in a variety of forms and for different periods of time. Others prefer early mobilization programs. We present results for twenty-eight children with thirty-seven flexor tendon injuries. The average age was 5.8 years. After primary tendon suture in children six years and younger (group A), our postoperative program consisted of immobilization for three weeks. The older children (group B) were treated with an early passive mobilization program. Follow-up examinations were carried out on twenty six of the children at three months and at 3.7 years. Three months after surgery, the children in group A showed only average results while those in group B presented good finger motion. After 3.7 years both groups showed good results.

Adolescent↗
PubMed2004

Rehabilitation after surgery for flexor tendon injuries in the hand.

BACKGROUND: Postoperative rehabilitation of the flexor tendons in the hand consists of a short period of immobilisation while pain and swelling diminish, followed by progressive mobilisation to maximize the range of motion of the affected fingers. By altering the time of immobilisation and the manner of subsequent mobilisation different rehabilitation regimes are created. OBJECTIVES: To determine, with evidence from randomised controlled trials, the optimal rehabilitation strategy after surgery for flexor tendon injuries in the hand. SEARCH STRATEGY: We searched the Cochrane Musculoskeletal Injuries Group specialised register (November 2002), the Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 4, 2002), MEDLINE (1966 to November 2002), EMBASE (1988 to November 2002), CINAHL (1982 to October 2002), CURRENT CONTENTS (1993 to October 2002), PEDro - The Physiotherapy Evidence Database (http://ptwww.cchs.usyd.edu.au/pedro/ accessed 30/10/2002) and reference lists of articles. SELECTION CRITERIA: All randomised and quasi-randomised controlled trials of interventions for rehabilitation after surgery of flexor tendon injuries in the hand after surgery. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed trial quality, using a 10 item scale, and extracted data where possible. Additional information was sought from trialists when required. Due to the lack of extractable data and the variety of interventions used, pooling was not attempted. Where possible relative risks and 95 per cent confidence intervals were calculated for dichotomous outcomes, and mean differences and 95 per cent confidence intervals calculated for continuous outcomes. MAIN RESULTS: Six trials, including three reported only in abstracts, with a total of 464 participants were included. Data were not pooled. One trial compared continuous passive motion (CPM) with controlled intermittent passive motion (CIPM) and found a significant difference in mean active motion favouring CPM (WMD 19.00 degrees, 95% CI 15.11 to 22.89). One trial compared a shortened passive flexion/active extension programme with a normal passive flexion/active extension mobilisation programme, and reported (without data) a significant reduction in absence from work of 2.1 weeks in favour of the shortened programme. Other trials compared active flexion with rubber band traction, early controlled active mobilisation with early controlled passive mobilisation and dynamic splintage versus static splintage. No trials found significant differences in overall functioning or complication rate. REVIEWERS' CONCLUSIONS: Controlled mobilisation regimens are widely employed in rehabilitation after flexor tendon repair in the hand. This review found insufficient evidence from randomised controlled trials to define the best mobilisation strategy.

Finger Injuries↗
PubMed1992

Principles of rehabilitation after chronic tendon injuries.

This article describes a framework for the evaluation, diagnosis, and management of tendon injuries that result from repetitive microtrauma overload. These injuries are commonly called tendinitis injuries, but are more often degenerative lesions. The initial management of acute tendon injuries with rupture is usually quite different than that of chronic injuries, but the functional rehabilitation of the acute injuries can follow the same framework.

Chronic Disease↗
PubMed1986

Closed tendon injuries of the hand in athletics.

Closed tendon injuries in the hand are common in the athlete. Neglect of such injuries may result in irreparable damage to the hand. Even seemingly minor injuries must be carefully evaluated and treated by a physician. Early diagnosis, accurate and precise treatment, and proper rehabilitation are extremely important to regain optimal function after these injuries. Most of the injuries can be controlled by conservative means. However, when surgical repair is indicated, it is important for the surgeon to be trained and familiar with the anatomy and techniques of surgery of the hand.

Athletic Injuries↗
PubMed1985

Tendon injuries--flexor surface.

Because of the difficulties in reconstructing chronic, unrecognized tendon injuries, early diagnosis and proper management are of the utmost importance. The initial examining physician is key to the treatment pathway the patient will take. A high index of suspicion for possible injuries to deep structures beneath the laceration followed by appropriate examination of each of the involved parts will usually result in an accurate diagnosis.

Fingers↗