• U Moehrlen, L Mazzone, C Bieli, and D M Weber.
• Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland.
• Eur J Pediatr Surg. 2009 Apr 1;19(2):83-6.

PurposeAim of the study was to provide an age-adapted rehabilitation protocol for flexor tendon repairs of children and to evaluate a patient series accordingly.MethodsA modified Kessler's technique was used to repair 49 flexor tendon injuries in 39 children. All children had immediate postoperative mobilization according to the protocol that provides specific guidelines for preschoolers, children and teenagers. Range of motion was monitored and the final results were evaluated retrospectively.ResultsAll children could be treated successfully according to the protocol with no occurrence of secondary tendon ruptures. Forty finger injuries were evaluated according to the Strickland classification, resulting in a median total active motion of 92.6 % with 29 (72.5 %) excellent results, 8 (20 %) good results, 3 (7.5 %) fair results and no poor result. All 7 thumbs had an excellent result according to the Buck-Gramcko score. There was no significant difference in outcomes between the three age groups.ConclusionsThe rehabilitation protocol provided in this study allows an age-adapted early mobilization of children's hands after flexor tendon injuries. It respects age-specific limitations in rehabilitation and takes a child's superior healing capacity compared to adults into account. The good results and the very low complication rate observed in the present series suggest that the extra effort of early mobilization may be justified.

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