X-Ray Stereophotogrammetric Examinations of Flexor Tendon Excursion in the Tendon Sheath Area after Tendon Repair

Abstract

A number of early controlled mobilization techniques following direct repair of flexor tendons have been established and described to improve the final results.^{2,5,6,7,8,9,11,13,18} The efficiency of the different methods are, however, not well documented, controlled clinical studies are rare and there are also negative reports.⁴¹⁹ Lane et al.¹² found in an experimental study a rapid decrease in tendon gliding occurring within hours of the surgical procedure. They concluded that postoperative hematoma and edema restricted gliding long before collagenous adhesions were synthesized. This may be an explanation to unpredictable results from passive mobilization methods in cases where peroperative tendon gliding were satisfactory. Would then the addition of limited active flexion be necessary in these cases and could that be performed without excessive dehiscence? An investigational method is needed to study the effects of different controlled mobilization techniques on tendon excursion at the level of injury and the gap formation in the tendon repair during the treatment. In this study, Roentgen stereophotogrammetric analysis (RSA) has been applied on tendon tissues for clinical studies on movements of flexor profundus tendons during different postoperative treatments.