Wrist & HandFunctional outcomes of a modified Duran postoperative rehabilitation protocol after primary repairs of pediatric hand flexor tendon injuriesLin, James S.a; Balch Samora, Juliea,b Author Information aDepartment of Orthopaedics, The Ohio State University bDepartment of Orthopedic Surgery, Nationwide Children’s Hospital, Columbus, Ohio, USA Received 25 June 2021 Accepted 21 November 2021 Correspondence to Julie Balch Samora, MD, PhD, Department of Orthopedic Surgery, T2E-A2700, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA, Tel: +1 614 722 3373; e-mail: [email protected] Journal of Pediatric Orthopaedics B: November 2022 - Volume 31 - Issue 6 - p 597-602 doi: 10.1097/BPB.0000000000000944 Buy Metrics Abstract The objective of this study was to determine whether pediatric patients undergoing flexor tendon repair who underwent 4 weeks of immobilization followed by a modified Duran controlled passive motion rehabilitation protocol will have favorable outcomes. A study was performed at a tertiary pediatric hospital of patients <18 years who underwent primary flexor tendon repairs in zones 1–4. Outcomes were calculated by total active motion and classified by the original Strickland criteria or Buck-Gramcko criteria. Twenty-eight patients with 34 injured fingers were included. Mean age was 11.4 years (range 2.4–17.9) with 17 males (61%) and 11 females (39%). Thirty-five percent of injuries occurred in zone 1; 35% zone 2; 6% zone 3; and 24% zone 4. All underwent a modified Duran postoperative rehabilitation protocol following a period of immobilization. The majority of patients achieved favorable outcomes, with 86% of cases classified as good/excellent. Thirty (88%) cases received surgery acutely (within 3 weeks). Of these, 70% achieved excellent outcomes, 17% good, and 13% fair. Four (12%) chronic cases underwent primary repair (range 24–68 days), achieving excellent outcomes in 50%, good in 25%, and fair in 25%. Three (75%) patients with delayed primary repair exhibited stiffness, which was greater than the 17% of patients with acute repairs (P = 0.03). Approximately 1 month of immobilization followed by a modified Duran rehabilitation protocol leads to favorable outcomes in children with flexor tendon repairs. Children with delayed surgery (>3 weeks) who underwent primary repair generally still achieved good outcomes but were more likely to have stiffness. Level of evidence: III. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.