Which flexor tendon repair protocol would represent best practice standards for a Zone 2 flexor digitorum superficialis laceration in a 10-year-old?

Which flexor tendon repair protocol would represent best practice standards for a Zone 2 flexor digitorum superficialis laceration in a 10-year-old?

• A. Active mobilization approach
• B. Immobilization approach
• C. Passive mobilization approach
• D. Controlled early active mobilization approach

Answer: (B)

Protection of the repaired tendon during the initial healing window is the key idea. A Zone II flexor digitorum superficialis repair in a child is particularly vulnerable to rupture if motion is started too soon, because the repair site sits in a tight, high-stress area where tendon forces are common during finger use. Immobilizing the finger in a protective posture for an initial period minimizes tensile load on the repair and allows scar and tendon-to-sheath healing to consolidate, which is especially important in a 10-year-old whose tissues will heal but still benefit from controlled protection. After this immobilization phase, a carefully graded progression to motion is introduced to restore glide and prevent stiffness, but the early steps prioritize protecting the repair. While early motion can reduce adhesions in some adults, the safest, most standard approach for this scenario in a child is initial immobilization to shield the repair and allow proper healing before moving toward controlled mobilization.

Protection of the repaired tendon during the initial healing window is the key idea. A Zone II flexor digitorum superficialis repair in a child is particularly vulnerable to rupture if motion is started too soon, because the repair site sits in a tight, high-stress area where tendon forces are common during finger use. Immobilizing the finger in a protective posture for an initial period minimizes tensile load on the repair and allows scar and tendon-to-sheath healing to consolidate, which is especially important in a 10-year-old whose tissues will heal but still benefit from controlled protection. After this immobilization phase, a carefully graded progression to motion is introduced to restore glide and prevent stiffness, but the early steps prioritize protecting the repair. While early motion can reduce adhesions in some adults, the safest, most standard approach for this scenario in a child is initial immobilization to shield the repair and allow proper healing before moving toward controlled mobilization.