Abstract
The wide-awake approach to flexor tendon repair has decreased our rupture and tenolysis rates, and permitted us to get consistently good results in cooperative patients. We no longer perform flexor tendon repair with the tourniquet, sedation and muscle paralysis of general or block (Bier or axillary) anesthesia. Injection of only lidocaine with epinephrine wherever incisions will be made in the finger and hand permits comfortable tourniquet-free awake patients cooperate with active finger full flexion and extension testing during the surgery. 5 main reasons that I never want to do a flexor tendon repair asleep or with a motor block ever again
Highlights
From 10th Congress of the Asia-Pacific Federation of Societies of Surgery fo the Hand and the 6th Congress of Asia-Pacific Federation of Societies of Hand Therapists Kuala Lumpur, Malaysia. 2-4 October 2014
None of the 102 patients who followed proper postoperative instructions with true active early protected movement ruptured after surgery
2) Seeing a full fist of flexion and full active extension during the surgery without gap gives us the confidence to know they will not rupture with half a fist of flexion and half full extension with protected movement 3 days after the surgery We no longer use Kleinert rubber bands or “place and hold” with protected post-operative active movement
Summary
From 10th Congress of the Asia-Pacific Federation of Societies of Surgery fo the Hand and the 6th Congress of Asia-Pacific Federation of Societies of Hand Therapists Kuala Lumpur, Malaysia. 2-4 October 2014. The wide-awake approach to flexor tendon repair has decreased our rupture and tenolysis rates, and permitted us to get consistently good results in cooperative patients. Injection of only lidocaine with epinephrine wherever incisions will be made in the finger and hand permits comfortable tourniquet-free awake patients cooperate with active finger full flexion and extension testing during the surgery.
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