Primary Repair with Indiana Method in Zone II Flexor Tendon Rupture

Journal of the Korean Society for Surgery of the Hand 2000;5(1):91-97.
Published online January 1, 2000.

Young Ho Kwon, Won Jae Song

수부의 ZoneII 굴곡 건파열에서 Indiana Method에 의한 일차 봉합

권영호, 송원재

Abstract

Purpose
: This article was designed to assess the result of early passive motion following primary tendon repair with Indiana method in zone II, compared to delayed motion and early motion of Kleinert method following primary repair with modified Kessler method. Material and Method : We reviewed the results of 19 primary flexor tendon repairs in zone II. Seven patients were treated with controlled early passive mobilization as rehabilitation program following tendon repair with Indiana method (Group I). Ten patients were managed with delayed mobilization following tendon repair with modified Kessler method (Group II). Two patients were managed with early motion of Kleinert using rubber band following tendon repair with modified Kessler method (Group III). In order to assess digital performance following Zone II flexor repair, we compared the frequency of complication and recovery of digital motion used by Total Active Motion (TAM) system of American Society for Surgery of the Hand. Result : There were one case of tendon re-rupture and two cases of adhesion in group II, but no case of complication in group I. In comparison of digital motion recovery used by total active motion system, there were excellent 4 cases, good 2 cases, fair 1 case in group I. There were excellent 2 cases, good 3 cases, fair 3 cases and poor 2 cases in group II. And in group III, good 2cases. Conclusion : Because Indiana method provides sufficient tensile strength on suture site, early mobilization is possible without rupture. Controlled early passive mobilization as rehabilitation program produces sufficient range of digital motion by minimizing adhesion formation. The result suggests that controlled early passive mobilization following tendon repair with Indiana method in zone II produces satisfactory functional motion and reduces complications such as rupture & adhesion formation due to sufficient tensile strength on suture site.