Zone II Flexor Tendon Repair by Modified Brunelli Pullout Technique and Very Early Active Mobilization

J Hand Surg Am. 2019 Sep;44(9):804.e1-804.e6. doi: 10.1016/j.jhsa.2019.03.014. Epub 2019 May 22.

Abstract

Numerous surgical methods and hand therapy protocols have been described in attempts to improve the functional outcome after flexor tendons repair in zone II. It is generally accepted that the best functional results can be obtained by combining a surgical technique, which provides enough strength of the repair, with very early postoperative mobilization. One of the methods to achieve these goals seems to be the Brunelli pullout technique, which moves the tension from the suture level to the finger pulp. We describe here our modifications to the original Brunelli technique, which, by moving the tension from the suture level and by diminishing the gap, allows immediate postoperative mobilization.

Keywords: Flexor tendons; immediate mobilization; pullout technique; zone II.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Debridement
  • Finger Injuries / surgery*
  • Humans
  • Suture Techniques
  • Tendon Injuries / surgery*
  • Wound Healing