Among the FLEXOR TENDONs in the horse's limbs, the superficial digital FLEXOR TENDON is more prone to damage than the deep digital FLEXOR TENDON. SDF TENDONitis is a common injury in event horses. Recovery of superficial digital FLEXOR TENDON (SDFT) injuries is slow, but re-injury is likely. SDF TENDON injuries are more common in the forelimb. FLEXOR TENDON injuries are due to strain on the TENDON or a direct trauma. TENDON damage vary from inflammation and pain to complete rupture of the TENDON. Injuries caused by strain are associated with swelling that require ultrasound assessment to confirm the diagnosis. Treatment for these injuries includes anti-inflammatory treatment, which is initially followed by a rehabilitation program. In cases where drug treatment is not responsive, surgical procedures including TENDON splitting and superior check ligament desmotomy can be used. In this study, we briefly review the TENDONitis of the superficial digital FLEXOR TENDON, etiology, clinical signs, diagnosis, treatment and prognosis.

Background: FLEXOR TENDON injury is one of the unanswered problems in reconstructive surgery of the hand. Although pull out method is one of the best reconstructive approaches but still is controversial. Surgeons prefer immobilization to prevent laceration at the site of the suture but it may cause adhesion and lead to surgical failure. The aim of this study was to perform a new surgical method to achieve a TENDON repair without these problems.Methods: In this case-series study, 80 fingers with FLEXOR TENDON impairment selected and divided into four groups (TENDON laceration & avulsion, TENDON graft reconstructed in 1 & 2 stages) then patients were surgically treated by the new technique. The most important aspect of the technique is the placement of the suture in the direction of strength therefore, following any tension the suture would be tighter and this point help us to mobilize the injured TENDON immediately after the surgery then we analyzed the results depends on the patient’s group.Results: The pull out and surgical (functional) results were evaluated. 97% of the pull out results were good and 3% were poor and surgical results were 23.9% excellent, 52.2% good, 17.9% fair and 6% poor. Conclusion: Depend on the acceptable results, immobilization in these patients is unnecessary & active and passive range of motion would be gradually increased as soon as possible. However biomechanical studies would be beneficial to evaluate this suture influence and designing future studies to compare this technique with old methods would be essential.

Background: FLEXOR TENDON injures, especially in zone II, need primary repair. It is obvious that in case of not repairing it primarily or repair failure, one or two-stage FLEXOR TENDON reconstruction become necessary. The aim of this study was to determine the results of two-stage reconstruction of hand FLEXOR TENDONs in zone II.Methods: In a cross-sectional study, all patients underwent two-stage reconstruction surgery of finger FLEXOR TENDON in Alzahra and Kashani hospitals in Isfahan from 2001 to 2007 were selected in a simple- sampling method. Age, sex, mechanism of injury, initial performed treatment, along with lesions (digital nerves or arteries), presence or absence of local and phalanges fractures, motion weakness sensory status of finger at the admitting time, indication for reconstruction, rate of improvement and ultimate satisfaction was recorded.Finding: Thirty one patients with average age of 26.09±9.62 years that 71% of them were men were included in the study. Before operation, 87.1% of patients had weak finger range of motion; 3 months after operation, 67.7% of them had relatively weak range of motion at the end of study only; 25.8% of patients had very weak range of motion 6 moths after surgery (P<0.001).45.2% of patients were satisfied and none of them were unsatisfied or completely unsatisfied.Conclusion: Two-stage FLEXOR TENDON reconstruction in hand in zone two is the method of choice for secondary repair or managing TENDON repair complications.

Background: Lacerations of FLEXOR TENDONs are among the common soft tissue injuries of upper limb, which are often caused by broken glass, or other penetrating wounds. The aim of this study is to report the treatment outcome of such injures in zone V.Methods: In a 14- month period, 30 consecutive cases of FLEXOR TENDON laceration in zone V that were repaired by a modified Kessler technique in Ahvaz teaching centers were prospectively followed with a minimum follow-up of six months. The cases were assessed by Buck-Gramcko scoring system.Results: 120 finger FLEXOR TENDONs, consisting of 18 thumbs and 102 fingers were repaired. The patients had a mean age of 23 years, and each patient had a mean number of 4 TENDONs repaired. The functional results were excellent in 85 (70.62%), good in 6 (5.28%) and poor in 29 (24.1%) fingers. Seventeen patients could return to their original occupation.Conclusions: Repair of zone V FLEXOR TENDON injury in our hand had satisfactory results in only 76 percent of cases, and resulted in inability to return to pre-injury occupation in about half of the cases.

Introduction: Palliative TENDON transfer procedures for radial nerve palsy are continuing to evolve.There is a big history behind this procedure. Many studies are done and they have gradually led to describe two basic methods of transfer, using the FLEXOR Carpi Ulnaris (FCU) or the FLEXOR Carpi Radialis (FCR) for transfer. There are some differences in cosmetic and functional results of these surgical plans. This study was done to compare these two methods.Methods: This study was done in Alzahra (SA) and Kashani hospitals in Isfahan. 41 known cases of chronic radial nerve palsy that had the inclusion criteria were selected during 7 years. They had divided into 2 groups randomly. In one group, we used FCR and in the other one we used FCU to restore fingers (metacarpophalangeal joint) extension. Post operative plan was the same in both groups. A questionnaire was designed and each patient was evaluated by physical exam. The collected data was analyzed by SPSS software. The chi square, t, and Fischer tests were used for data analyzing.Results: There was significant difference between fingers active extension, Ulnar deviation and cosmetic results in two groups (P<0.05). The difference between wrist extension, infection and scar formation was not significant (P>0.05).Conclusion: The use of FCR method had better results in our study. We recommend this method if the patient does not have any contra indications.

Background: In FLEXOR Pollicis Longus (FPL) injuries, primary repair with end-to-end suture is the treatment of choice. In cases where primary repair is not possible, TENDON transfer or TENDON grafting is used, each of which has its strengths and weaknesses. We aimed to investigate the effectiveness of each of the above two methods in patients. Methods: Patients with FPL injury who referred to Hazrat Fatemeh Hospital, Tehran, Iran late in 2020 to 2021, if primary TENDON repair was not possible, were randomly repaired with TENDON transfer or TENDON graft. After the appropriate time, the splint was opened and physiotherapy was performed for the patients. Then, at least three months after the repair, the range of motion of the IP and MP joints of the patients thumb was measured and compared in two groups. Results: Ten patients in the TENDON transfer group and 10 patients in the TENDON graft group were studied. In the secondary repair of FPL with TENDON grafting, the range of motion of both IP and MP joints of the thumb was not significantly different compared to repair with TENDON transfer. Conclusion: The findings of this research confirm controversies in this field. In order to obtain more accurate results, it is suggested to carry out a research with a larger number of patients and with strict control over the surgical technique and post-operative care, as well as taking into account the morbidities caused by donor TENDON removal and examining the overall satisfaction of the patients.

Tibialis posterior muscle dysfunction leading to adult acquired flatfoot deformity. Tibialis posterior muscledysfunction is commonly treated with a FLEXOR digitorum longus TENDON transfer to the tubercle of navicularbone. In recent years, the dynamic computer modeling has been used to predict the results of surgical andtreatment. The aim of this study was to provide a dynamic computer model of FLEXOR digitorum longus TENDONtransfer for predicting the outcome of flat foot treatment. In this study the 3D model of ankle joint, whichconsists of 29 bones and 12 muscles was developed in OpenSim. Using software, ankle plantar flexion moment,metatarsophalangeal joints moment and inversion moment of subtalar joint were drawn. After FLEXOR digitorumlongus TENDON transfer, there were decreases ankle plantar flexion moment (6.7%), metatarsophalangeal jointsmoment (45%) and inversion moment of subtalar joint (34%). Plantar flexion moment reduction caused nosignificant changes in the ankle joint, but reduction in metatarsophalangeal joints could limit heel lift duringpropulsive phase in walking or running. A decreased inversion moment at the subtalar joint could alter thebiomechanics of lower extremities.

Objectives: The objective was to determine the results of early active controlled motion in the patients rehabilitated by our new protocol.Methods: 91 fingers in 64 patients with FLEXOR TENDON repair in all zones were enrolled in a single group (quasi-experimental) clinical trial.58 fingers in 43 patients were assessed at least three months postoperatively. Outcomes were defined using the ‘White’ criteria for thumbs and the ‘Strickland’ criteria for other fingers.Results: The results for range of motion of fingers were Excellent in 70.7%, good in 13.8%, fair in 6.9% and poor in 8.6%. There were 3 (5.17%) postoperative TENDON ruptures.Discussion: Early active controlled motion with our rehabilitation protocol shows acceptable postoperative results.This rehabilitation protocol is more effective if carried out from the 1st to 4th weeks after surgery, under the supervision of a surgeon or hand therapist. Then, from the 4th to 6th weeks, it should be performed at a hand therapy clinic and from the 6th to 12th weeks at home, supervised by a hand therapist.

Background. FLEXOR TENDON repair damage to both deep and superficial FLEXOR TENDONs injuries, especially in zone II, has special importance that distinguishes it from other zones. This study evaluated the effect of atorvastatin, a cheap, available, and non-cytotoxic drug, on the adhesion phenomenon resulting from tissue repair. Methods. Overall, 52 patients were included in this study. Patients were randomly divided into two groups. In the first group, atorvastatin 20 mg was administered daily for three weeks. In the control group, a placebo was used for three weeks. After 3 months, the range of motion, extension gap, extension lag, and flexion gap for each finger were measured and compared in the two groups. Results. Based on the results, using atorvastatin led to an increase in the range of motion in distal interphalangeal (DIP) injured patients. In addition, extension, flexion gap, and extension lag in both groups were the same. The rate of improvement in the range of motion in smokers was significantly lower. Conclusion. Using atorvastatin in surgical patients appears to be effective in increasing the range of motion of DIP and improving this adhesion. The negative effects of smoke on the rate of improvement that have been investigated in limited studies in this area should not be ignored either. Practical Implications. In surgery to repair the FLEXOR TENDON, using atorvastatin has really helped improve the ability to move the DIP joint. Patients are also asked to stop smoking temporarily to make their recovery go faster.