الفهرس 
RehablitationOnly 14 pages are availabe for public view
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Abstract
Flexor tendons injuries are very common thing that we interface daily, so we focused on this subject .To understand the repair of the flexor tendons we must know the anatomy, biomechanics and healing of the tendons. There are different zones of the hand for flexor tendons with each zone have its special anatomy.
However, still Zone II is the most difficult zone, because its special circumstances of the pulley system which is very important to repair to prevent bowstring, Zone III, IV and V are also important because at these areas there is missing of the neurovascular bundles, also tendon cut is very common to be missed.
Tendon repair include core suture, epitendinous suture and sheath repair. There are multiple techniques for core suture, two strand repair (Bunnel, Kessler and modified Kessler) ,four strand repair(Strickland, cruciate, and locked cruciate), six strand techniques (Savage, Yoshizu, and Lim).
There will continue to be modifications of current methods or entirely new approaches to this difficult problem as additional scientific studies support those changes. We already recognize that the “ideal” tendon suture technique does not yet exist .
In this prospective study, 22 patients with 46 acute flexor tendon lesions were studied prospectively, where primary flexor tendon repair was carried out and then the patients were followed up for an average duration of 6 months . On reviewing the results of our study : we should strive to create a method that will ensure equal tension on all suture strands, reduce the number of knots, and if possible, eliminate knots from the repair site. In addition, we need to improve the techniques that ensure dorsal placement of the sutures and minimize the bulk of the repair site and the coefficient of friction produced by the repair as it glides under the annular pulleys of the sheath.
Six strands as core suture for acute flexor tendon injuries is an effective method of repair it guarantees strong repair which allows early active mobilization postoperatively . we achieved 91,2% of our patient good to excellent results .
from our point of view, and based on the successful results reported in our study, we could conclude that early active mobilization as post-operative protocol conducted by competent therapist is to be recommended. Early active mobilization allows for more tendon excursion, a factor that clearly accelerates rehabilitation and favors outcome .
The most threatening complication was rupture of the repaired tendons. Our strong core suture didn’t guarantee elimination of this complication . However , the rate of rupture was less than other methods(4%) of repair which used core sutures weaker than our such as modified Kessler (6.5%).