Tendon excursions after flexor tendon repair in zone. II: Results with a new controlled-motion program.

Metal markers were used to study flexor digitorum profundus tendon excursions during early controlled motion with a new program combining dynamic traction and passive flexion to all four digits. The mean excursion was 2.3 mm along the middle phalanx and 11.7 mm along the proximal phalanx. This was more than twice the mean size of excursions previously achieved with a modified traditional Kleinert traction program. The mean excursion per 10 degrees of combined distal and proximal interphalangeal controlled joint motion amounted to 73% of the corresponding excursion recorded during active motion. Taken together with the findings of our previous study on tendon excursions, the results also indicate that the magnitude of excursions induced by both the distal and the proximal interphalangeal joints during controlled motion has a significant effect on adhesion formation and clinical results. However, in the region of 6 to 9 mm there appears to be a threshold beyond which the effect of a further increase in excursions becomes insignificant.