Treatment of flexor tendon injuries in children

Abstract

Injuries to the flexor tendons in children are less common than in adults. The clinical examination and diagnostics require extensive experience. Leaving flexor tendons untreated will result in growth disorders of the affected finger. Therefore, the indications for operative exploration of any type of open injury in achild's hand should be liberally applied. As for adults the primary treatment of flexor tendon injuries as an emergency is rarely indicated. In the recent literature various tendon suture techniques and rehabilitation protocols have been differently assessed. According to the Ulm algorithm flexor tendon injuries in children are treated by a2-strand core stitch technique followed by acontinuous circular suture. Children under 6years of age are postoperatively immobilized for 3weeks with a fist bandage. Children older than 6years are treated like adults with a dynamic aftercare as described by Kleinert for 5weeks. The results are comparable with those of other aftercare protocols.