JBJS | Flexor Tendon Repair and Rehabilitation : State of the Art in 2002

The Journal of Bone & Joint Surgery, Volume 84, Issue 9

Instructional Course Lecture | September 01, 2002

Flexor Tendon Repair and Rehabilitation : State of the Art in 2002

Martin I. Boyer, MD, FRCS(C); James W. Strickland, MD; Drew R. Engles, MD; Kavi Sachar, MD; Fraser J. Leversedge, MD

The Journal of Bone & Joint Surgery. 2002; 84:1684-1706

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Major advances in the understanding of intrasynovial flexor tendon repair and rehabilitation have been made since the early 1970s ^1,2 , when reports first demonstrated that flexor tendon lacerations within the fibro-osseous digital sheath could be repaired primarily, and rehabilitation could be successful, without tendon excision and delayed grafting ³ . The concept of adhesion-free, or intrinsic, tendon-healing-namely, the idea that tendons could heal primarily without the ingrowth of fibrous adhesions from the surrounding sheathï¿½has been validated both experimentally and clinically in studies over the past twenty years ^4-13 . Recent attempts to understand and improve the results of intrasynovial flexor tendon repair have focused on restoration of the gliding surface ^11,14-23 , on the biomechanics at the repair site ^24-36 , and on the molecular biology of early tendon healing ^37-47 . The goals of the surgical treatment of intrasynovial flexor tendon lacerations have remained unchanged: they include achievement of a primary tendon repair of sufficient tensile strength to allow application of a postoperative passive-motion rehabilitation protocol that inhibits formation of intrasynovial adhesions, stimulates restoration of the gliding surface, and facilitates healing of the repair site ⁴⁸ .

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Topics

reconstructive surgical procedures ; tendon ; rehabilitation ; flexor tendon ; flexor tendon repair ; tendon transplantation ; cicatrix ; transplantation ; adhesions ; sutures

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These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.

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