{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:43:31Z","timestamp":1785329011120,"version":"3.55.0"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T00:00:00Z","timestamp":1699401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Indian J Plast Surg"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Flexor tendon injury zone V is a multicomponent soft tissue injury involving tendons, nerves, and vessels. Outcome assessment of repair thus requires evaluation of the hand as a whole rather than solely evaluating tendon function. The purpose of this Preferred Reporting Items for Systematic Reviews and Meta-Analyses -compliant systematic review was to identify and assess the components of outcome measures used in flexor zone V.<\/jats:p><jats:p>\n          Methods\u2003A total of 3,761 studies were retrieved from four databases (PubMed, ProQuest, Cochrane Central, and Google Scholar). These studies were then screened for inclusion using a validated screening form. Fifteen articles fulfilling the eligibility criteria were included in the review. Subsequently, the included studies were assessed for methodological quality using the Joanna Brigg Institute tool.<\/jats:p><jats:p>\n          Results\u2003Out of the 15 studies, 11 were case series, 3 were cross-sectional studies, and 1 was a randomized controlled trial. Out of 15 included studies, 13 were of low risk, whereas 2 studies suggested moderate risk when assessed for methodological quality using the Joanna Brigg Institute tool. Eight outcome measures were identified, out of which the most frequently used were Total Active Motion by the American Society for Surgery of Hand (TAM-ASSH) and Noaman's criteria. Our study found that Noaman's criteria assessed sensory-motor function and finger deformity in addition to the range of motion (ROM), which was found to be assessed by all the other outcome measures.<\/jats:p><jats:p>\n          Conclusion\u2003We concluded that although Buck-Gramcko criteria is well suited for the ROM evaluation, Noaman's criteria, a recently developed outcome measure used exclusively for combined injuries in zone V, took into consideration the implications of nerve injury along with tendon function. Although being specifically designed for combined injuries of tendons, nerves, and vessels in zone V, there is a lack of usage of Noaman's in the literature. There still exists a lack of a consistent and appropriate choice of outcome measure.<\/jats:p>","DOI":"10.1055\/s-0043-1775864","type":"journal-article","created":{"date-parts":[[2023,11,9]],"date-time":"2023-11-09T00:11:22Z","timestamp":1699488682000},"page":"480-487","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of Outcome Measures of Zone V Flexor Tendon Injury: A Systematic Review"],"prefix":"10.1055","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5133-5562","authenticated-orcid":false,"given":"Iris","family":"Cardoz Lobo","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1610-2258","authenticated-orcid":false,"given":"Sonali","family":"Manek","sequence":"additional","affiliation":[{"name":"Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4526-1437","authenticated-orcid":false,"given":"Krutika","family":"Bhosale","sequence":"additional","affiliation":[{"name":"Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3432-0251","authenticated-orcid":false,"given":"Chhaya","family":"Verma","sequence":"additional","affiliation":[{"name":"Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8117-8374","authenticated-orcid":false,"given":"Maksud","family":"Devale","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9688-8312","authenticated-orcid":false,"given":"Aditi","family":"Parekh","sequence":"additional","affiliation":[{"name":"Physiotherapy School and Centre, Topiwala National Medical College and B Y L Nair Charitable Hospital, Mumbai Central, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4348-8897","authenticated-orcid":false,"given":"Priyanka","family":"Kerketta","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1016\/j.jcot.2019.08.005","article-title":"Flexor tendon injuries","volume":"10","author":"H Venkatramani","year":"2019","journal-title":"J Clin Orthop Trauma"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/S0363-5023(83)80275-5","article-title":"Report of the Committee on Tendon Injuries (International Federation of Societies for Surgery of the Hand)","volume":"8","author":"H E Kleinert","year":"1983","journal-title":"J Hand Surg Am"},{"key":"ref3","first-page":"60","volume-title":"Anatomy and kinesiology of the hand","author":"R A Chase","year":"2002"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jpra.2018.06.003","article-title":"An extensive volar forearm laceration\u2014the spaghetti wrist: a systematic review","volume":"18","author":"K Koshy","year":"2018","journal-title":"JPRAS Open"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1097\/00006534-198505000-00018","article-title":"Results of treatment of extensive volar wrist lacerations: the spaghetti wrist","volume":"75","author":"C L Puckett","year":"1985","journal-title":"Plast Reconstr Surg"},{"issue":"03","key":"ref6","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1097\/00000658-194103000-00009","article-title":"The rate of healing of tendons: an experimental study of tensile strength","volume":"113","author":"M L Mason","year":"1941","journal-title":"Ann Surg"},{"issue":"02","key":"ref7","first-page":"65","article-title":"[Evaluation criteria in follow-up studies of flexor tendon therapy]","volume":"8","author":"D Buck-Gramcko","year":"1976","journal-title":"Handchirurgie"},{"issue":"06","key":"ref8","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S0363-5023(80)80101-8","article-title":"Digital function following flexor tendon repair in Zone II: a comparison of immobilization and controlled passive motion techniques","volume":"5","author":"J W Strickland","year":"1980","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref9","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1197\/j.jht.2005.02.009","article-title":"Measurement of health outcomes following tendon and nerve repair","volume":"18","author":"J C MacDermid","year":"2005","journal-title":"J Hand Ther"},{"issue":"02","key":"ref10","doi-asserted-by":"crossref","first-page":"256","DOI":"10.5958\/j.0973-5674.8.2.095","article-title":"Compare outcome measures in flexor tendon repair of different zones following supervised controlled active mobilization","volume":"8","author":"S K Tejashree","year":"2014","journal-title":"Indian J Physiother Occup Ther"},{"issue":"05","key":"ref11","first-page":"290","article-title":"[How congruent is the rating of the results of flexor tendon injury repairs using the scores by Buck-Gramcko, Strickland, and the American Society for Surgery of the Hand?]","volume":"48","author":"P Hahn","year":"2016","journal-title":"Handchir Mikrochir Plast Chir"},{"issue":"71","key":"ref12","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"M J Page","year":"2021","journal-title":"BMJ"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/0363-5023(90)90105-Z","article-title":"Evaluation of results in flexor tendon repair: a critical analysis of five methods in ninety-five digits","volume":"15","author":"Y C So","year":"1990","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref15","first-page":"255","article-title":"Functional outcome and medicolegal implications of flexor tendon injuries at the wrist","volume":"30","author":"S A Al-Shanawany","year":"2003","journal-title":"Egypt Rheumatol Rehabil"},{"issue":"02","key":"ref16","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1258\/ht.2012.012005","article-title":"Is there a correlation between patient-reported outcome assessed by the disabilities of the arm, shoulder and hand questionnaire and total active motion after flexor tendon repair?","volume":"17","author":"P E Magnani","year":"2012","journal-title":"Hand Ther"},{"issue":"06","key":"ref17","doi-asserted-by":"crossref","first-page":"913e","DOI":"10.1097\/PRS.0000000000000749","article-title":"Improving results of flexor tendon repair and rehabilitation","volume":"134","author":"J KF Wong","year":"2014","journal-title":"Plast Reconstr Surg"},{"issue":"06","key":"ref18","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1002\/micr.20400","article-title":"Management and functional outcomes of combined injuries of flexor tendons, nerves, and vessels at the wrist","volume":"27","author":"H H Noaman","year":"2007","journal-title":"Microsurgery"},{"issue":"01","key":"ref19","first-page":"1","article-title":"Acute volar wrist injuries: evaluation, management and rehabilitation","volume":"5","author":"H Altamimy","year":"2017","journal-title":"Int. J Life Sci"},{"issue":"05","key":"ref20","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.hansur.2021.06.006","article-title":"Management of spaghetti wrist under WALANT technique","volume":"40","author":"H O Arik","year":"2021","journal-title":"Hand Surg Rehabil"},{"key":"ref21","first-page":"161","article-title":"Spaghetti wrist: good prognosis with adequate surgical technique and early physiotherapy","volume":"34","author":"K K El-Lamie","year":"2010","journal-title":"Egypt. J Plast Reconstr Surg."},{"issue":"03","key":"ref22","first-page":"77","article-title":"Repair and rehabilitation of zone five flexor tendon injuries of the wrist","volume":"2","author":"G Hegazy","year":"2016","journal-title":"Orthopedics and Rheumatology Open Access Journals."},{"issue":"01","key":"ref23","first-page":"43","article-title":"Functional outcome of flexor tendon repair of the hand at Zone 5 and post operative early mobilization of the fingers","volume":"29","author":"S A Mehdi Nasab","year":"2013","journal-title":"Pak J Med Sci"},{"issue":"03","key":"ref24","first-page":"194","article-title":"Flexor Zone 5 cut injuries: emergency management and outcome","volume":"24","author":"M S Raza","year":"2014","journal-title":"J Coll Physicians Surg Pak"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"128","DOI":"10.5958\/0973-5674.2018.00023.0","article-title":"Effectiveness of Kleinert's controlled motion protocol on tendon gliding following zone 5 flexor tendon repair","volume":"12","author":"J Uday Raj","year":"2018","journal-title":"Indian J Physiother Occup Ther"},{"issue":"04","key":"ref26","doi-asserted-by":"crossref","first-page":"193","DOI":"10.3233\/BMR-2010-0266","article-title":"Evaluation of postoperative early mobilization in patients with repaired flexor tendons of the wrist, the spaghetti wrist","volume":"23","author":"A Yildirim","year":"2010","journal-title":"J Back Musculoskeletal Rehabil"},{"issue":"03","key":"ref27","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0749-0712(03)00028-3","article-title":"The assessment of flexor tendon function after primary tendon repair","volume":"19","author":"D Elliot","year":"2003","journal-title":"Hand Clin"},{"issue":"06","key":"ref28","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S0363-5023(77)80025-7","article-title":"Primary flexor tendon repair followed by immediate controlled mobilization","volume":"2","author":"G D Lister","year":"1977","journal-title":"J Hand Surg Am"},{"issue":"03","key":"ref29","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/0363-5023(93)90083-F","article-title":"Measurement of range of motion of the finger after flexor tendon repair in zone II of the hand","volume":"18","author":"C W Jansen","year":"1993","journal-title":"J Hand Surg Am"},{"issue":"05","key":"ref30","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1080\/00015458.2006.11679952","article-title":"Evaluation and functional assessment of flexor tendon repair in the hand","volume":"106","author":"K Libberecht","year":"2006","journal-title":"Acta Chir Belg"},{"issue":"02","key":"ref31","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jhsa.2004.07.009","article-title":"Optimizing independent finger flexion with zone V flexor repairs using the Massachusetts General Hospital flexor tenorrhaphy and early protected active motion","volume":"30","author":"B J Wilhelmi","year":"2005","journal-title":"J Hand Surg Am"},{"issue":"02","key":"ref32","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.hcl.2004.11.005","article-title":"Clinical outcomes associated with flexor tendon repair","volume":"21","author":"J B Tang","year":"2005","journal-title":"Hand Clin"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.jht.2018.06.001","article-title":"Flexor tendon rehabilitation in the 21st century: a systematic review","volume":"32","author":"R L Neiduski","year":"2019","journal-title":"J Hand Ther"},{"issue":"01","key":"ref34","first-page":"CD012479","article-title":"Rehabilitation following surgery for flexor tendon injuries of the hand","volume":"1","author":"S E Peters","year":"2021","journal-title":"Cochrane Database Syst Rev"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/1471-2474-9-139","article-title":"ICF components of corresponding outcome measures 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years?","volume":"7","author":"C M Sugrue","year":"2019","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"06","key":"ref39","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.hansur.2021.07.009","article-title":"Combined nerve, vessel, and tendon injuries of the volar wrist: Multidisciplinary treatment and functional outcomes","volume":"40","author":"E Boynuyogun","year":"2021","journal-title":"Hand Surgery and Rehabilitation"},{"issue":"03","key":"ref40","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.hansur.2018.02.001","article-title":"Surgical treatment and functional outcomes of multicomponent soft tissue injuries of the wrist","volume":"37","author":"C Demirdover","year":"2018","journal-title":"Hand Surgery and Rehabilitation"},{"issue":"05","key":"ref41","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/S0266-7681(98)80019-3","article-title":"A Prospective Study of Flexor Tendon Repair in Zone 5","volume":"23","author":"N W Yii","year":"1998","journal-title":"Journal of Hand Surgery"},{"issue":"01","key":"ref42","doi-asserted-by":"crossref","first-page":"11","DOI":"10.46903\/gjms\/17.01.1857","article-title":"Frequency, Distribution and Treatment of Acute Flexor Tendon Injuries In Zone V of Hand","volume":"17","author":"M Shafiq","year":"2019","journal-title":"Gomal Journal of Medical Sciences"},{"issue":"03","key":"ref43","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1055\/s-0036-1586487","article-title":"Treatment and postsurgery functional outcome of spaghetti wrist","volume":"8","author":"H Yazdanshenas","year":"2016","journal-title":"Journal of Hand and Microsurgery"}],"container-title":["Indian Journal of Plastic 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