Article

The aim of this study was to compare anatomic and functional
improvements in zone II and zone V flexor tendon injuries and to determine the
effect of injury level on disability. DESIGN: Seventeen patients
(53 digits) with
zone V and 14 patients (25 digits) with repaired zone II flexor tendon injuries
were enrolled in this study.
All patients were treated with Modified Kleinert
protocol and followed up for a median of 60 mos. The anatomic improvement was
assessed by total active motion scoring system of the American Society for
Surgery of the Hand. Quick Disability of the Arm, Shoulder, and Hand (Quick DASH)
questionnaire and the grip strength value were used for the evaluation of
functional improvement. RESULTS: Two groups were similar with respect to age (P =
0.147), sex (P = 0.889), type of repair (P = 0.453), and follow-up period (P =
0.499). According to total active motion scoring system, good to excellent
results (75%-100% of the normal total active motion value) were achieved in 52%
of the digits with zone II and 83% of digits with zone V flexor tendon injuries
(P = 0.004). The recovery in the grip strength, in comparison with the uninjured
hand, has been found to be 71% and 53% in zone II and zone V injuries,
respectively (P = 0.112).
There was no difference between Quick DASH index scores
of two groups (P = 0.721). The grip strength percentage (r = -0.435; P = 0.014)
and total active motion recovery results (r = -0.541; P = 0.002) of the patients
were moderately correlated with Quick DASH scores. CONCLUSIONS: Early passive
mobilization in patients with zone V injuries resulted in higher percentage of
good to excellent results when compared with zone II injuries. However, this does
not translate into recovery in grip strength and disability.
This study suggests
that although the level of the injury is an important factor for the anatomic
improvement, it may not be the predictor of functional improvement.

Langue : ANGLAIS