Repair and functional exercise of flexor tendon rupture

  There are a variety of sutures that can be used to repair a ruptured flexor tendon in the finger, but the goal of all sutures is to provide sufficient strength to the tendon to meet the needs of tendon healing.  Early healing of the tendon is actually a process of adhesion and scar formation, so if the flexor tendon suture is immobilized for three weeks, this can go a long way toward ensuring that the tendon suture heals well. However, this also leads to a problem of adhesions between the tendon and the surrounding tissue, which can severely affect the joint movement of the finger and needs to be addressed by postoperative functional exercises or, if this is not effective, by secondary release through surgery. For this reason, it is now advocated to perform the strongest possible suture during the intraoperative repair to provide for postoperative functional exercise, based on which early (two days postoperatively) functional exercise is performed to avoid adhesions.  However, the ensuing problem is that early exercise leads to an increase in the percentage of tendon rupture after suturing, where the main reason is that the method and strength of the suture does not meet the exercise requirements, followed by a lack of correct functional exercise. This leads to the need for reoperation, and multiple operations can make the operation more difficult and the postoperative recovery less effective. Therefore, suturing and functional exercise after flexor tendon injury is a problem that needs to be paid attention to.