Comparison Of Outcome Of 1- And 2-Knot, 4-Strand, Doublemodified Kessler Flexor Tendon Repair With Early Active Mobilization Protocol In Patients With Flexor Tendon Lacerations Of Hand

J Ayub Med Coll Abbottabad. Oct-Dec 2018;30(4):544-547.


Background: Hand is unique for the dexterity of its function and flexor tendons have most important function in hand. Its injury is a challenging treatment. Purpose of this study is to compare the success of 1- and 2-knot, flexor tendon repair (good to excellent results) with early active mobilization in terms of total active motion (TAM) of affected hand postoperatively.

Methods: Hundred patients with age range of 5-70 years of age presenting with flexor tendon lacerations of hand were included in the study. Subjects were randomly divided into Group A, who underwent flexor tendon repair using 4 strands of double modified Kessler repair with 1 knot and Group B, in which 4 strand double modified Kessler repair with 2 knot technique was used. All patients followed early active motion protocol started in first 48 hours. They were followed at 3, 6 and 8 weeks after surgery for TAM. Data was entered and analysed in SPSS-21.0. Frequency and percentages were calculated for outcome of procedure.

Results: In group A 89.8% (44) of patients had good to excellent results in terms of total active motion (TAM) as compared with 90.9% (40) in group B using early active mobilization protocol.

Conclusions: The study concluded that that four strand double modified flexor tendon repair using either 1 or 2 knot technique are excellent choices of repair with early active mobilization protocols.

Keywords: 4 strand repair; Flexor tendon injuries;; Total active motion; Early active mobilization.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Female
  • Finger Injuries / surgery*
  • Humans
  • Lacerations / surgery
  • Male
  • Middle Aged
  • Random Allocation
  • Range of Motion, Articular
  • Suture Techniques*
  • Tendon Injuries / surgery*
  • Young Adult