Gap formation after flexor tendon repair in zone II. Results with a new controlled motion programme.

Intratendinous metal markers were used to study gap formation in 36 flexor digitorum profundus repairs during and after early controlled motion with a programme combining dynamic traction and passive flexion to all four digits. The mean gap 3 weeks after operation was 2.5 mm. The mean final gap was 2.6 mm. The results of linear regression analysis showed that gap formation within the observed range from 0 to 8.5 mm did not negatively affect tendon excursions or clinical results in terms of active interphalangeal joint range of motion. These findings are in accordance with the results of a previous study of gap formation in patients treated with a modified traditional Kleinert traction programme. Together the two studies confirm that controlled motion is effective in restricting the adhesions associated with gap formation during postoperative immobilisation.