Results of flexor tendon grafting with early active mobilization

Abstract

Objective The aim was to evaluate the results of early active motion regimen after hand flexor tendon grafting. Background The application of proper postoperative rehabilitation program is an integral part to achieve good results after hand flexor tendon grafting. The aim of application of early, active mobilization rehabilitation program is to limit adhesion formation which limits active motion. Patients and methods Twenty-three fingers were managed by flexor tendon grafting and assessed from February 2015 till August 2016 at Menoufia University Hospital. In all, 17 fingers had two stages tendon grafting and six fingers had single-stage tendon grafting. Early active mobilization rehabilitation regimen was applied for all patients. Postoperative assessment was done by the American Society for Surgery of the Hand system, Strickland system, Buck-Gramcko method, and LaSalle formula. Results Final assessment was done at 6 months postoperatively and the results were as follows: good (52.17%), fair (39.13%), and poor (8.7%) according to the American Society for Surgery of the Hand system. According to the Strickland system, the results were excellent (13.04%), good (34.78%), fair (39.13%) and poor (13.04%). According to the Buck-Gramcko score, the results were excellent (21.7%), very good (17.4%), good (39.1%) good, fair (8.7%), and poor. (13.1%) According to LaSalle formula, the results were excellent (34.78%), good (52.17%), fair (8.7%), and poor (4.4%). Complications were adhesion formation (8.7%), infection (8.7%), flexor pulley rupture (4.3%), graft rupture (4.3%), and tourniquet palsy (4.3%). Conclusion The results were found to be affected by sex, dominance of affected hand, affected tendon(s), flexor pulley integrity, type of procedure, and by the type of tendon graft.