EARLY ACTIVE MOBILIZATION OF TEND ON GRAFTS USING MESH REINFORCED SUTURE TECHNIQUES

The flexor digitorum profundus tendon in 11 digits with division of bo th flexor tendons in zone 2 was reconstructed with a palmaris longus t endon graft in a two-stage procedure, The distal and proximal fixation of the graft was reinforced with a polyester mesh sleeve placed aroun d the ends of the graft during stage 1, All digits were mobilized with a combination of active extension and active and passive flexion with in 3 days of the second stage, There were three ruptures, one due to f aulty technique and two due to falls on outstretched hands during alco hol intoxication and football, Excluding the ruptures, the mean active composite distal and proximal interphalangeal joint range of motion 6 weeks and 6 months post-operatively was 141 degrees and 136 degrees r espectively, The results indicate that palmaris longus tendon grafts c an survive and heal during early active mobilization, with few or no a dhesions of functional significance. The techniques described here rep resent one possible approach to the safe implementation of early activ e mobilization after tendon grafting procedures.