Results of Flexor Tendon Repair of the Hand in Children Below Six Years of Age

Study Overview
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Brief Summary
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The incidence of flexor tendon injuries in pediatric patients has remained largely undocumented, with a frequency of 3.6 per 100 000 persons per year.The pediatric literature demonstrates a higher prevalence of flexor tendon injuries in men, caused by sharp objects (glass or knife)

Detailed Description
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The diagnosis of flexor tendon injuries is more challenging in younger children than in adults . and delayed diagnosis in children is common . An innocuous appearing skin wound and a subtle functional deficit may hinder both presentation and identification of the injury.Pediatric flexor tendon injuries heal rapidly and contractures are rare, as long as the joint has not been injured. but Inadequate management can result in loss of hand function . Data involving children rehabilitation remain unclear, with some studies showing no difference between early rehabilitation protocols and four weeks of cast immobilization . Some studies claim that protocols are not necessary in children younger than six years of age, and that only immobilization is required and some studies show transition to a more aggressive early motion protocol . Although the incidince of flexor tendon injury in children is not low but the reported cases below the age of six years remains low Which makes reported results less trustworthy. This created the need for a better designed and larger number study to report results in this age group.

Official Title
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Results of Flexor Tendon Repair of the Hand in Children Below Six Yera Sof Age

Conditions
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Flexor Tendon Rupture

Intervention / Treatment
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* Procedure: 4 strand technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute flexor tendon injuries of the hand in both genders. All flexor zones are included. Cooperative patients aged between 0-6 years. Exclusion Criteria: Uncooperative patients such as psychologically disturbed patients , who will not be able to follow the strict of protocol Age more than six years old . Associated fractures close to the tendon injury. Vascular injury requiring revascularization

Ages Eligible for Study
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Minimum Age: 1 Day
Maximum Age: 6 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: prospective cohort study
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: children below six years<br>children below sex years both genders | Procedure: 4 strand technique<br>* 4 strand technique reapir of tendin flexor injury<br>|
| Active Comparator: cooperative children<br>repair of the tendos by modified kessler | Procedure: 4 strand technique<br>* 4 strand technique reapir of tendin flexor injury<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| range of motion of flexor tendon after repair according total active motion criteria | above elbow cast fo four weeks | follow up the patients up to one year |