Flexor tendon repair in no-man's-land: results of primary repair with controlled mobilization

Fifty-three patients with 60 injuries within the digital sheath, which were treated with primary tendon repair by the Kleinert technique, had follow-up of 6 to 36 months after operation. Seventeen digits had isolated lesions of the profundus tendon and regained an average 38 degrees range of motion (ROM) in the distal interphalangeal (DIP) joint. Forty-three digits had injuries to both the profundus and superficialis tendons, 35 of which flexed within 2 cm from the distal palmar crease (81%), and 21 had a total active motion of at least 200 degrees (49%). The average active ROM in the DIP joint was 30 degrees. The results were superior to our own results with primary repair by the Verdan technique. Comparison with our own results after secondary tendon repair by the Kleinert technique showed that repair of isolated profundus lesions could be done primarily or secondarily within 1 month of injury with equally good results. Primary repair of double tendon lesions gave better results than secondary repair.