Flexor Tendon Repairs Flashcards
blood supply to flexor tendons
from the vinculae supplied by the digital arteries
healing of flexor tendons comes from
the blood supply and the synovial fluid
when is the flexor tendon weakest?
inflammatory phase (0-2 weeks)
tensile strength
the amount of force the tendon will tolerate before rupture
most important flexor tendon pulleys
A2 and A4 (prevent bowstringing)
FTR sutures
2, 4, or 6 strands*need to know number of strands used to select the appropriate protocol
FTR rehab approaches (3)
- immobilization2. immediate passive motion in the direction of the repair3. immediate active motion in the direction of the repair
FTR immobilization use
rarely usedmay be used for children, limited cognition, or severe fractures
FTR immobilization complications
adhesions and joint stiffness
FTR immobilization orthosis
dorsal blocking orthosis wrist 20-30 deg flexionMP 50-60 deg flexionIP full extension
FTR immediate passive flexion orthosis
dorsal blocking orthosiswith static IP positioning or elastic traction*may use elastic traction during day and strap in extension at night
FTR immediate active flexion use
be selective on which patients you do this onpreferably at least 4 strand repairconsider edemamultiple protocols
FTR immediate active flexion orthosis
protective dorsal blocking orthosis
FTR wrist positioning
least tension in flexor tendons during flexion is with the wrist in slight extension
FTR early immediate active flexion goal
light fist with DIP flexion NOT FORCEFUL