Evaluation of the results of early mobilization following flexor tendon repair of fingers

Immobilization and splinting after tendon repair, have traditionally been used as part of the treatment protocol for tendon injuries in fingers. There has always been a debate about the duration of immobilization among surgeons, because some complications after tendon repair are attributed to prolonged immobilization. In this study, the results of early mobilization following flexor tendon repair of fingers, have been evaluated. In a clinical trial, 192 patients with acute injury of FDP in Zone II who underwent tendon repair were studied. Those with simultaneous extensor injury, dorsal and volar injuries, fracture and nerve injury were excluded. In 48 cases, splints were removed after 14 days and in 144 cases (control group), immobilization was applied for 28 days. After splint removal both groups underwent physiotherapy for three month and final functional outcome was assessed according to Buck-Gramcko scale. In the study group 67 tendons were treated with four strand method and short term immobilization. In 45 tendon repairs, (67%) excellent results were obtained in 11 cases, (16.5%), results were good, fair result in 6 cases (9%) and in 5 cases (7.5%) the result was poor. In two cases (4%), tendon rupture occurred during physiotherapy and had to be repaired again. In the control group, 185 tendons were repaired in which excellent results were attained in 133 cases, (72%), good result in 31 cases, (16.7%), fair result in 12 cases (6.5%) and poor result in 5 cases (2.7%). Comparison of results in these two groups does not show any significant statistical difference, (P= 0.316). Results of early mobilization after tendon repair are comparable with prolonged immobilization after repair. Hence, immobilization could be reduced to 2 -3 weeks.