Aggressive active mobilization following zone II flexor tendon repair using a two-strand heavy-gauge locking loop technique

In vitro and in vivo experimental studies have shown that a new two-strand technique increases the tensile strength of flexor tendon repair and eliminates gap formation at the healing repair site. The purpose of the current study was to clinically evaluate the new technique, followed by an aggressive active mobilization program. Seven digits with zone II flexor tendon lacerations were treated using the technique, employing a heavy (2-0) braided polyester suture. The patients were encouraged to perform active mobilization of the injured digits by themselves with almost a full range of flexion and extension after they were instructed by the surgeon for few days from the first postoperative day. All patients were followed up for at least 6 months, except for one, with whom contact was lost in 14 weeks postoperatively. Six of the seven digits were evaluated as excellent in 6 months by the original Strickland criteria, thus showing that the combination of the new repair technique and aggressive active mobilization is effective for zone II flexor tendon repair.