{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:08:30Z","timestamp":1785305310656,"version":"3.55.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,2,19]],"date-time":"2018-02-19T00:00:00Z","timestamp":1518998400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hand Surg Eur Vol"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p>We report outcomes in 29 patients with flexor tendon repairs in 32 digits (five thumbs and 27 fingers) with our modified protocols. We repaired the lacerated flexor digitorum profundus tendons with core suture repairs using the 6-strand M-Tang method and without circumferential sutures. We divided the pulleys as much as needed to allow excursion of the repaired tendons, including complete division of the A4 or A2 pulleys when necessary. In nine fingers, we repaired one slip of the flexor digitorum superficialis tendon and resected the other half. When the flexor digitorum profundus tendon would not glide under the A2 pulley, we excised the remaining slip of the flexor digitorum superficialis tendon. The wrist was splinted in mild extension post-surgery with early commencement of tenodesis exercises. No tendon repair ruptured. By the Strickland criteria, out of 27 fingers, 18 had excellent, six had good, two had fair, and one had poor results. We conclude that a strong core suture (such as the M-Tang repair) without peripheral sutures, and with division of pulleys as necessary is safe for early active motion and yields good outcomes.<\/jats:p>\n                  <jats:p>Level of evidence: IV<\/jats:p>","DOI":"10.1177\/1753193418758269","type":"journal-article","created":{"date-parts":[[2018,2,20]],"date-time":"2018-02-20T00:35:59Z","timestamp":1519086959000},"page":"474-479","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":63,"title":["Flexor tendon repair in the hand with the M-Tang technique (without peripheral sutures), pulley division, and early active motion"],"prefix":"10.1177","volume":"43","author":[{"given":"Thomas","family":"Giesen","sequence":"first","affiliation":[{"name":"Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Reissner","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inga","family":"Besmens","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Politikou","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Calcagni","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,2,19]]},"reference":[{"key":"bibr1-1753193418758269","first-page":"65","volume":"8","author":"Buck-Gramcko D","year":"1976","journal-title":"Handchirurgie"},{"key":"bibr2-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2013.03.001"},{"key":"bibr3-1753193418758269","doi-asserted-by":"crossref","unstructured":"Elliot D, Lalonde DH, Tang JB. Commentaries on Clinical results of releasing the entire A2 pulley after flexor tendon repair in zone 2C. K. Moriya, T. Yoshizu, N. Tsubokawa, H. Narisawa, K. Hara and Y. Maki. J Hand Surg Eur. 2016, 41: 822\u20138. J Hand Surg Eur. 2016, 41: 829\u201330.","DOI":"10.1177\/1753193416655932"},{"key":"bibr4-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(94)90126-0"},{"key":"bibr5-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2010.11.041"},{"key":"bibr50-1753193418758269","doi-asserted-by":"crossref","unstructured":"Giesen T, Calcagni M, Elliot D. Primary flexor tendon repair with early active motion: experience in Europe.\n                      Hand Clin\n                      . 2017; 33: 465\u201372.","DOI":"10.1016\/j.hcl.2017.03.001"},{"key":"bibr6-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193408096025"},{"key":"bibr7-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416681967"},{"key":"bibr8-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193417728427"},{"key":"bibr9-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2013.02.009"},{"key":"bibr11-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1054\/jhsb.1999.0319"},{"key":"bibr12-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416646521"},{"key":"bibr13-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193415619082"},{"key":"bibr14-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193417715213"},{"key":"bibr15-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193417723238"},{"key":"bibr16-1753193418758269","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.6891"},{"key":"bibr17-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416657758"},{"key":"bibr18-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1054\/JHSB.1999.0230"},{"key":"bibr19-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(80)80101-8"},{"key":"bibr20-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2004.11.005"},{"key":"bibr21-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/J.JHSB.2006.12.009"},{"key":"bibr22-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/17531934097321"},{"key":"bibr23-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2013.02.007"},{"key":"bibr24-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416641590"},{"key":"bibr25-1753193418758269","first-page":"254","volume":"18","author":"Tang JB","year":"1999","journal-title":"Chir Main"},{"key":"bibr26-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1016\/S0266-7681(03)00019-6"},{"key":"bibr27-1753193418758269","doi-asserted-by":"publisher","DOI":"10.1177\/1753193417691390"}],"container-title":["Journal of Hand Surgery (European Volume)"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753193418758269","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1753193418758269","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1753193418758269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:48:38Z","timestamp":1777502918000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1753193418758269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,19]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1177\/1753193418758269"],"URL":"https:\/\/doi.org\/10.1177\/1753193418758269","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,19]]}}}