Mclarney Technique and controlled mobilization in pediatric hand flexor tendon injuries
Keywords:
flexor tendons of the hand, McLarney technique, controlled active mobilization.Abstract
Introduction: Pediatric hand injuries have increased over the years, especially those of the flexor tendons.
Objectives: To evaluate McLarney technique and controlled active mobilization in the treatment of injuries to the flexor tendons of the hand in schoolchildren and adolescents.
Methods: A longitudinal, retrospective and prospective descriptive study was carried out with 32 fingers with flexor tendon injuries (18 patients) of schoolchildren and adolescents, diagnosed and treated at the Orthopedics and Traumatology services of Juan Manuel Márquez Pediatric Teaching Hospital, and Frank País International Orthopedic Scientific Complex from January 2020 to May 2023.
Results: Ages 12-18 years and males predominated. The index finger was the most affected, as was zone II. 75.0% of the treated fingers presented joint trauma to the superficial and deep flexor tendons, and 93.8% had no associated nerve injury or postoperative complications. The final functional results were considered good.
Conclusions: The use of McLarney tendon suture, plus controlled active rehabilitation, showed high effectiveness in hand flexor injuries in the triphalangeal fingers and thumbs.
Downloads
References
Dogliotti A, Dogliotti P. Traumatismo de la mano infantil. En: Coiffman F (compilador). Cirugía plástica reconstructiva y estética. 3 ed. Bogotá, Colombia: Actualidades médico odontológicas Latinoamérica (AMOLCA); 2008. p. 3936-60.
Espinal C. Caracterización de los flexores de la mano [Tesis de grado]. Holguín, Cuba: Universidad de Ciencias Médicas de Holguín; 2022.
Boyer MI. Flexor tendon injury. En: Green D, Hotchkiss R, Pederson W, Wolfe S, editores. Green´s operative surgery. 5 ed. Philadelphia: Elsevier Churchill Livingstone; 2015. p. 219-40.
Santos A. Reparación de los flexores de la mano. Rev Esp Cirug Ort Traumatol. 2001 [acceso 29/06/2023];45(2):91-8. Disponible en: https://www.elsevier.es/es-revista-revista-espanola-cirugia-ortopedica-traumatologia-129-articulo-reparacion-los-flexores-mano-13013722
Arons MS. Purposeful delay of the primary repair of cut flexor tendons in "some-man's-land" in children. Plast Reconstr Surg. 1974;53(6):638-42. DOI: https://doi.org/10.1097/00006534-197406000-00004
Nietosvaara Y, Lindfors NC, Palmu S, Rautakorpi S, Ristaniemi N. Flexor tendon injuries in pediatric patients. J Hand Surg Am. 2007;32(10):1549-57. DOI: https://doi.org/10.1016/j.jhsa.2007.08.006
Tableb C, Liverneaux P. Lesiones recientes de los tendones flexores de los dedos. EMC Técn Quirúrg Ort Traumatol. 2016;8(4):1-10. DOI: https://doi.org/10.1016/S2211-033X(16)80744-6
Angeles J, Heminger H, Mass D. Comparative biomechanical performances of 4 strand core suture repairs for zone II flexor tendon lacerations. J Hand Surg Am. 2002;27(3):508-17. DOI: https://doi.org/10.1053/jhsu.2002.32619
Martel O, Thams C, Perez C, Yanez A, Cuadrado A. Estudio comparativo de suturas empleadas en la reparación de los tendones flexores de la mano. XXII Congreso Nacional Ingeniera Mecánica Madrid. 2018 [acceso 15/06/2023]. Disponible en: https://accedacris.ulpgc.es/handle/10553/106048
Mackenney E, Perea D, Hernández P. Lesiones aguda de los tendones flexores. Rev Iberoam Cirug Mano. 2010;38(2):086-93. DOI: http://dx.doi.org/10.1055/s-0037-1606769
Huynh M, Ghumman A, Agarwal A, Malic C. Outcomes after flexor tendon injuries in the pediatric population: A 10-year retrospective review. Hand (NY). 2022;17(2):278-84. DOI: https://doi.org/10.1177%2F1558944720926651
Timotheus S. Management of extensor tendon injuries in paediatric and adolescent patients [Tesis de grado]. Graz, Austria: Medical University of Graz; 2015.
Vergara E, Hernández MA. Lesiones de tendones flexores en niños. Sobre una serie de casos. Rev Sal Uninorte. 2017;34(2):253-62. DOI: https://doi.org/10.14482/sun.34.2.616.75
Sikora S, Lai M, Arneja JS. Pediatric flexor tendon injuries: A 10-year outcome analysis. Can J Plast Surg. 2013;21(3):181-5. DOI: https://doi.org/10.1177/229255031302100304
Cooper L, W Khor, Burr N, Sivakumar B. Reparaciones del tendón flexor en niños: resultados de un centro terciario especializado. J Plast Reconstr Aesthet Surg. 2015;68(5):717-23. DOI: https://doi.org/10.1016/j.bjps.2014.12.024
Starr BW, Cornwall R. Pediatric flexor tendon injuries. Hand Clin. 2023;39(2):227-33. DOI: https://doi.org/10.1016/j.hcl.2022.08.022
Ortiz J. Rehabilitación de los tendones flexores en la zona II. ¿Qué aspectos debemos tener en cuenta a la hora de abordar a los pacientes? Rev Asoc Argent Ortop Traumatol. 2021;86(5). DOI: https://doi.org/10.15417/issn.1852-7434.2021.86.5.1346
Venkatramani H, Varadharajan, Bhardwaj P, Vallurupalli A, Sabapathy R. Flexor tendon injuries. J Clin Orthop Trauma. 2019;10(5):853-61. DOI: https://doi.org/10.1016/j.jcot.2019.08.005
Klifto CS, Bookman J, Paksima N. Postsurgical rehabilitation of flexor tendon injuries. J Hand Surg Am. 2019;44(8):680-6. DOI: https://doi.org/10.1016/j.jhsa.2019.02.010
Tang JB. Flexor tendon injuries. Clin Plast Surg. 2019;46(3):295-306. DOI: https://doi.org/10.1016/j.cps.2019.02.003
Garay AL, Martínez CE, Patiño JM, Tonetto G, López BF. Avance tendinoso no convencional para lesiones en las zonas I y II de Verdan. Nueva técnica quirúrgica. Rev Asoc Argent Ortop Traumatol. 2020;85(Supl 1). DOI: https://doi.org/10.15417/issn.1852-7434.2020.85.4s.1173
Bitar EM, Gaviria S, León N, Gallego S. Epidemiología del trauma de miembro superior atendido en seis instituciones de salud de la ciudad de Medellín, Colombia, en 2016. Cir Plást Iberolatinoam. 2021;47(3):323-32. DOI: https://dx.doi.org/10.4321/s0376-78922021000300014
Flores CI, Luna JC. Protocolo de Durán modificado en rehabilitación precoz de lesiones tendinosas flexoras de la mano. Cuad Hosp Clín. 2019 [acceso 16/06/2023];60(1). Disponible en: http://www.scielo.org.bo/scielo.php?script=sci_arttext&pid=S1652-67762019000100003
