Zone 2 Flexor Tendon Repair in Young Children: A Comparative Study of Four-Strand Versus Two-Strand Repair

This study compares the active ranges of finger motion and rupture rates of two-strand and four-strand repairs in zone 2 flexor tendon lacerations in young children. A total of 29 patients (under the age of 4 years) with 32 flexor tendon lacerations in zone 2 were evaluated. The injured tendons were randomly repaired with either two-strand or four-strand modified Strickland techniques. At a mean follow-up period of 11 months, the mean total active motion of interphalangeal joints was 156° in the two-strand and 158° in the four-strand group. According to the Strickland original method, this means an average of 89% (range 57–100%) of normal function in the two-strand and 90% (range 60–100%) in the four-strand group. There were no ruptures of the four-strand repairs, but one two-strand repair failed within 3 weeks of the repair. Statistically, we were not able to show any significant difference in the active ranges of finger motion achieved with two-strand and four-strand repairs.