RESULTS OF ZONE-I AND ZONE-II FLEXOR TENDON REPAIRS IN CHILDREN

In a combined study of three hand surgery practices, 78 patients young er than 16 years who had sustained flexor tendon lacerations in zone I or zone II of 95 digits were available for critical evaluation. The a verage postrepair follow-up period was 24 months (range, 3-144 months) . Patient age was divided into three groups: 0-5 years, 6-10 years, an d 11-15 years. Performance of all digits was assessed to determine the percentage return of normal digital function following repair. Data w ere analyzed to determine the effect of age, the effect of varying per iods of postrepair immobilization, and the long-term changes in digita l performance resulting from growth. All profundus repairs in zone I r eturned excellent function. Isolated profundus and combined profundus and superficialis repairs in zone II achieved comparable results when managed with an early passive motion program or following immobilizati on for 3 or 4 weeks. Immobilization for longer than 4 weeks resulted i n an appreciable deterioration of function. Digital motion following z one II flexor digitorum profundus and superficialis injuries treated. with less than 4 weeks of immobilization or early motion was not signi ficantly different in the three age groups studied. Digits with associ ated digital nerve and/or palmar plate lacerations fared less favorabl y when compared with isolated tendon lacerations. In many digits, a mo dest improvement in digital motion was found when patients returned af ter several years of growth.