A six-strand technique for zone II flexor-tendon repair in children younger than 2 years of age

IntroductionA six-strand repair for zone II flexor-tendon repair in children younger than 2 years of age has not been reported in the literature because of the small size of the flexor tendon in this very young age group.PurposeThe aim is to introduce the use of a six-strand repair in zone II flexor-tendon repair in children younger than 2 years of age.MethodsA total of 12 children younger than 2 years, with 12 injured fingers, were treated over a 10-year period. A ‘profundus only’ repair was done using three separate ‘figure of eight’ core sutures and a continuous epitendinous suture. The repair site was bulky and ‘venting’ of the pulley system proximal to the repair site was done. The hand was immobilised for 3.5 weeks after surgery and then physiotherapy exercises were started. The final net range of motion at the interphalangeal joints was measured and the outcome was assessed as per the Strickland–Glogovac criteria.ResultsThere were no ruptures. The final outcome in range of motion was excellent in nine children and good in the remaining three children. None of the children required tenolysis.ConclusionOur six-strand technique is an alternative technique for zone II flexor-tendon repair in children younger than 2 years of age, but the bulky repair site requires a ‘profundus only’ repair and ‘venting’ of the pulley system.