Functional outcome of flexor tendon repair of the hand at zone 5 and post operative early mobilization of the fingers

There are few reports on outcome following flexor tendon repair of the hand in zone 5. We hypothesized that early mobilization of the fingers is possible if the suture site of repaired tendon is strong enough. The aim of this study was to assess the results of flexor tendon repair in this zone using modified Kessler method reinforced by peripheral running suture and a post operative early active and passive mobilization of the fingers. This prospective study was carried out between April 2006 and Feb 2010, and 171 digits flexor tendons cut in 42 patients were repaired by modified Kessler technique reinforced by running peripheral suture. Early active mobilization and gentle passive motion of the fingers was allowed in a dorsal wrist splint the day after surgery. Wrist Immobilization was performed for one month. Function of the tendons was assessed by Buck-Gramcko score at nine month follow up. Mean age of the patients was 25.4 years [range 17-46 y]. Twenty nine flexor policis longus, 77 flexor digitorum superficialis and 65 flexor digitorum profundus tendons of digits were repaired. Middle and index fingers were most commonly involved. Median and ulnar nerve repair was done in 17 and 12 cases respectively. Good to excellent results were seen in of 79.34% of FPL and 74.65% of other finger flexors. One case of FPL rupture was seen. Tenolysis of FDS was performed in one case. Recovery in thenar muscle function was good, fair and poor in 5, 2 and 10 cases after median nerve repair, while all 12 patients with ulnar nerve lesion showed some degrees of clawing of 4[th] and 5[th] fingers. Most patients following flexor tendon repair at zone 5 obtained good results. Early motion of the fingers seems to improve outcome in these patients. Concomitant nerve cut in particular of ulnar nerve were associated with a high rate of poor results

[Opium abuse among patients with chronic physical pain as a misleading cause in addiction treatment center]

Chronic non-cancer pain has been considered as causes of Opium addiction in human beings. The knowledge of its incidence as an initial reason for Opium consumption among Opium addict people may affect a] addiction prevention plans, b] addiction treatment programmes and even 3] educational goals for training medical students. Therefore, this study aimed to determine this incidence among Opium addict people referred to an addiction treatment center. This is a cross sectional study which was performed in Ahwaz during 2006-2008.First, a pilot study was carried out in which the study sample size was calculated. Participants were evaluated by physical examination, pain scaling via VAS, physical examination and psychological interview based on DSM4 criteria and SCL90 questionnaire. The obtained data were analyzed by descriptive analysis of SPSS and X square test. Finally, 21 patients out of 224 participants were found to suffer from a type of chronic physical pain before Opium addiction. Psychological abnormalities were more frequent in pain suffered patients [p<0.007]. There were some people who seek for getting rid of physical pain. But, they were deviating to a street drug abuse status. This issue should be considered in prevention and treatment of addiction