Results of zone I and zone II flexor tendon repairs in children.

In a combined study of three hand surgery practices, 78 patients younger than 16 years who had sustained flexor tendon lacerations in zone I or zone II of 95 digits were available for critical evaluation. The average postrepair follow-up period was 24 months (range, 3-144 months). Patient age was divided into three groups: 0-5 years, 6-10 years, and 11-15 years. Performance of all digits was assessed to determine the percentage return of normal digital function following repair. Data were analyzed to determine the effect of age, the effect of varying periods of postrepair immobilization, and the long-term changes in digital performance resulting from growth. All profundus repairs in zone I returned excellent function. Isolated profundus and combined profundus and superficialis repairs in zone II achieved comparable results when managed with an early passive motion program or following immobilization for 3 or 4 weeks. Immobilization for longer than 4 weeks resulted in an appreciable deterioration of function. Digital motion following zone II flexor digitorum profundus and superficialis injuries treated with less than 4 weeks of immobilization or early motion was not significantly different in the three age groups studied. Digits with associated digital nerve and/or palmar plate lacerations fared less favorably when compared with isolated tendon lacerations. In many digits, a modest improvement in digital motion was found when patients returned after several years of growth.