Long-term results after primary repairs of zone 2 flexor tendon lacerations in children younger than age 6 years

In young children, methods of primary flexor tendon repair in the digital canal are controversial. The authors reviewed 12 children younger than age 6 years with zone 2 flexor tendon repairs. The mean follow-up period was 8 years. In all cases, the flexor digitorum profundus tendons were repaired according to the Kessler modified technique and the hands were immobilized by an above-elbow cast. As for postoperative complications, there were no fingers with tendon rupture and two fingers with tendon adhesion. One finger needed tenolysis. The total active motion (TAM) in the interphalangeal joints evaluated with the Strickland formula averaged 155 degrees, and the TAM percentage averaged 89% (range 74%-100%). Eleven patients had an excellent result and one had a good result. The percentage phalangeal length averaged 99% (range 96%-100%). Functional motion and nearly normal growth of the finger can be expected after primary zone 2 flexor tendon repairs in children younger than age 6 years.