REHABILITATION AFTER FLEXOR TENDON INJURY: A COMPARATIVE REVIEW OF THE DURAN AND KLEINERT TECHNIQUES

Background/Objectives:Flexor tendon injuries, particularly those affecting the flexor digitorum profundus and flexor digitorum superficialis, are prevalent and often result from penetrating trauma or lacerations. Surgical repair, typically via end-to-end tendon suturing, is essential for restoring function. Postoperative rehabilitation is crucial to prevent complications such as adhesions, stiffness, and re-rupture. This study aims to evaluate the effectiveness of a combined rehabilitation regimen incorporating modified Kleinert and modified Duran protocols in enhancing functional outcomes following flexor tendon repair.

Materials and MethodsA systematic review was conducted to evaluate the benefits of combining the modified Kleinert and modified Duran protocols for flexor tendon rehabilitation. An initial search yielded 28 articles, of which 10 met the inclusion criteria based on relevance, study quality, and focus on combined rehabilitation techniques. The remaining 18 articles were excluded due to factors such as insufficient data, lack of focus on combined protocols, or methodological limitations.

All 10 included studies reported that the combined use of modified Kleinert and modified Duran protocols resulted in superior functional outcomes compared to the use of either protocol alone. These findings suggest that integrating both approaches may enhance tendon healing and functional recovery following flexor tendon repair.

ResultsThe systematic review indicates that combining the modified Kleinert and modified Duran rehabilitation protocols yields superior outcomes compared to using either protocol alone. Studies have demonstrated that this combined approach leads to improved functional recovery, reduced tendon rupture rates, and enhanced range of motion. For instance, a study reported that patients undergoing the combined regimen achieved excellent or good results in a significant majority of cases, with a rupture rate as low as 2.3% . Another study found that the combined protocol resulted in better total active motion and grip strength compared to other rehabilitation methods .PMC

ConclusionThe evidence suggests that a rehabilitation program integrating both modified Kleinert and modified Duran techniques is more effective than employing either protocol individually. This combined approach enhances tendon healing, minimizes complications such as adhesions and re-ruptures, and promotes better functional outcomes. Therefore, adopting a combined protocol may offer a more successful and productive strategy for flexor tendon injury rehabilitation.