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Flexor tendon repair with active motion program in children

patients. 28 consecutive children (2-15 year old)7 girls and 21 boys 68 flexor tendons45 fingerszone I 10, zone II 15, zone III 1, zone V 19associated nerve injuries in 15 childrenND 9, NC 1, ulnar 4, median 2. tendon repair. multi-strand in 33 fingers4- or 6-strand core suture (Tendoloop

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Flexor tendon repair with active motion program in children

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    1. Flexor tendon repair with active motion program in children Y. Nietosvaara, N. Lindfors, S. Palmu N. Suojanen, S. Rautakorpi Children’s Hospital, Helsinki University Central Hospital

    2. patients 28 consecutive children (2-15 year old) 7 girls and 21 boys 68 flexor tendons 45 fingers zone I 10, zone II 15, zone III 1, zone V 19 associated nerve injuries in 15 children ND 9, NC 1, ulnar 4, median 2

    3. tendon repair multi-strand in 33 fingers 4- or 6-strand core suture (Tendoloop® or Ticron®) 2-strand in 8 fingers pull-our refixation in 3 fingers free tendon graft in 1 finger

    4. post-operative program thermoplastic splint for 6 weeks (n=32) applied 1-3 days after tendon repair active exercises without the splint 5 repetitions four times a day follow-up at 1, 3, 5 and 7 weeks (OT) final follow-up at mean 3 years (1-6) cast immobilization (n=13) 2-strand core suture (n=8) 5 additional patients

    7. subjective results: function active mobilization (n=32) immobilization (n=13)

    8. results (TAM) normal wrist motion mean MP TAM 100% (91-117%) mean PIP TAM 98% (80-113%) mean DIP TAM 2-strand (immo) 41% vs. multi-strand (active) 73% (p=0.109) 3 out of 10 2-strand repairs ruptured 1 direct re-repair 1 free tendon graft 1 pending

    9. results (n=47 fingers) 45 primary operations + 2 repair for ruptures method: E G F P Buck-Gramcko 46 1 0 0 modified Strickland 35 10 0 0 ASSH-TAM 19 21 5 0 original Strickland 30 7 7 1 DIP-TAM 28 5 3 11

    10. conclusions multistrand flexor tendon repair with active motion program proved to be a reliable, patient and therapist friendly treatment protocol in children with good functional outcome

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