[The results of primary repair and early passive rehabilitation in zone II flexor tendon injuries in children]. / Cocuklarda ikinci bölge fleksör tendon yaralanmalarinda primer onarim ve erken pasif rehabilitasyon sonuçlari.

OBJECTIVES: We evaluated the results of zone II flexor tendon injuries treated by primary repair and early rehabilitation in children under the age of 14 years. METHODS: The study included 25 digits of 23 patients (12 boys, 11 girls; mean age 7 years; range 2 to 14 years) with appropriate follow-up. Sixteen patients underwent surgery within the first 24 hours, while the remaining patients had surgery in a mean of three days (range 2 to 14 days). Digital nerve injuries were detected in 10 digits (40%). Repair of the tendons was performed with the use of a modified Kessler technique followed by an above-elbow stabilization splint. Passive flexion-extension exercises were started on the postoperative first day according to the Duran technique. The results were evaluated according to the Glocovac and Strickland's criteria. The mean follow up period was 49 months (range 12 to 92 months). RESULTS: Functional results were excellent in 18 digits (72%), good in five digits (20%), fair in one digit (4%), and poor in one digit (4%). The mean total active movement was 78.5% (range 0% to 100%). No significant differences were observed in functional results with regard to age groups and the presence or absence of digital nerve injuries (p>0.05). No occurrences of infection were encountered. CONCLUSION: The results show that primary repair and early passive mobilization of zone II flexor tendon injuries in children yield satisfactory results.

[Clinical results of tibial pilon fractures treated by open reduction and internal fixation]. / Açik redüksiyon ve internal fiksasyon uygulanan tibia pilon kiriklarinda klinik sonuçlar.

OBJECTIVES: We evaluated the results of pilon fractures treated by open reduction and internal fixation. METHODS: The study included 18 patients (mean age 36 years; range 19 to 56 years) with pilon fractures. According to the Ruedi and Allgower's classification, there were three type I, nine type II, and six type III fractures. Five fractures were open including three of Gustilo-Anderson type II, and two fractures of type III. The results were assessed using the Burwell-Charnley criteria. The mean follow-up was 54 months (range 9 to 86 months). RESULTS: According to the Burwell-Charnley criteria, the results were good in 12 patients (66%), fair in three patients (17%), and poor in three patients (17%). The most common complication was posttraumatic degenerative arthritis, followed by wound infection (22%), Sudeck atrophy (22%), delayed union (17%), and angulation (11%). CONCLUSION: Early anatomical reduction, a stable fixation, early mobilization, and delayed weight-bearing seem to improve long-term results of treatment in pilon fractures caused by high energy trauma.