{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T06:40:09Z","timestamp":1778740809241,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T00:00:00Z","timestamp":1623974400000},"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":[[2021,10]]},"abstract":"<jats:p>We report the outcomes of delayed primary repair of flexor tendons in Zone 2 in 31 fingers and thumb (28 patients) averaging 15\u00a0days (range 4\u201337) after injury in 2020. The delay was longer than usual due to the COVID-19 pandemic. The tendons were repaired with a 6-strand core suture (M-Tang method) or a double Tsuge suture and a peripheral suture. This was followed by an early, partial-range, active flexion exercise programme. Adhesions in four digits required tenolysis. These patients were not with longest delay. Outcomes of two improved after tenolysis. The other two patients declined further surgery. One finger flexor tendon ruptured in early active motion. This was re-repaired, and final outcome was good. Overall excellent and good results using the Tang criteria were in 27 out of 31 fingers and thumbs (87%). The time elapsed between the injury and surgery is not an important risk factor for a good outcome, rather it depends on proper surgical methods, the surgeon's experience and early mobilization, properly applied. Adhesions may occur, but they can be managed with tenolysis.<\/jats:p>\n                  <jats:p>Level of evidence: IV<\/jats:p>","DOI":"10.1177\/17531934211024435","type":"journal-article","created":{"date-parts":[[2021,6,18]],"date-time":"2021-06-18T04:55:35Z","timestamp":1623992135000},"page":"818-824","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":18,"title":["Up to five-week delay in primary repair of Zone 2 flexor tendon injuries: outcomes and complications"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5413-7358","authenticated-orcid":false,"given":"Giovanni","family":"Munz","sequence":"first","affiliation":[{"name":"Unit of Surgery and Reconstructive Microsurgery of the Hand, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Poggetti","sequence":"additional","affiliation":[{"name":"Unit of Surgery and Reconstructive Microsurgery of the Hand, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Cenci","sequence":"additional","affiliation":[{"name":"Unit of Surgery and Reconstructive Microsurgery of the Hand, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna Rosa","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Unit of Surgery and Reconstructive Microsurgery of the Hand, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Biondi","sequence":"additional","affiliation":[{"name":"Unit of Surgery and Reconstructive Microsurgery of the Hand, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Pfanner","sequence":"additional","affiliation":[{"name":"Unit of Surgery and Reconstructive Microsurgery of the Hand, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,6,18]]},"reference":[{"key":"bibr1-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000003432"},{"key":"bibr2-17531934211024435","doi-asserted-by":"crossref","unstructured":"Bakhach J. The omega \u201c\u03a9\u201d flexor pulley plasty. In: Tang JB, Amadio PC, Guimberteau JC, Chang J (Eds.)\n                      Tendon surgery of the hand\n                      . Philadelphia, Elsevier, 2012: 104\u20139.","DOI":"10.1016\/B978-1-4377-2230-7.00011-3"},{"key":"bibr3-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.anplas.2005.06.002"},{"key":"bibr4-17531934211024435","first-page":"65","volume":"8","author":"Buck-Gramcko D","year":"1976","journal-title":"Handchirurgie"},{"key":"bibr5-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835518500479"},{"key":"bibr6-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2011.08.006"},{"key":"bibr7-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2015.04.016"},{"key":"bibr8-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1177\/1753193418758269"},{"key":"bibr9-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1142\/S0218810402001126"},{"key":"bibr10-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31820467b6"},{"key":"bibr11-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-198609000-00010"},{"key":"bibr12-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2014.09.004"},{"key":"bibr13-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2014.03.009"},{"key":"bibr14-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2015.08.019"},{"key":"bibr500-17531934211024435","doi-asserted-by":"crossref","unstructured":"Pan ZJ, Pan L, Fei Xu Y. Infrequent need for tenolysis after flexor tendon repair in zone 2 and true active motion: a four-year experience. J Hand Surg Eur. 2019a, 44: 865\u2013866.","DOI":"10.1177\/1753193419844157"},{"key":"bibr501-17531934211024435","doi-asserted-by":"crossref","unstructured":"Pan ZJ, Xu YF, Pan L, Chen J. Zone 2 flexor tendon repairs using a tensioned strong core suture, sparse peripheral stitches and early active motion: results in 60 fingers. J Hand Surg Eur. 2019b, 44: 361\u201336.","DOI":"10.1177\/1753193419826493"},{"key":"bibr15-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1177\/1753193417723238"},{"key":"bibr16-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2020.08.008"},{"key":"bibr17-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835519500218"},{"key":"bibr18-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/0266-7681(94)90054-X"},{"key":"bibr19-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/J.JHSB.2006.12.009"},{"key":"bibr20-17531934211024435","doi-asserted-by":"crossref","unstructured":"Tang JB. Indications for primary flexor tendon repair. In: Tang JB, Amadio PC, Guimberteau JC, Chang J (Eds.)\n                      Tendon surgery of the hand\n                      . Philadelphia, Elsevier, 2012a: 81\u20137.","DOI":"10.1016\/B978-1-4377-2230-7.00008-3"},{"key":"bibr21-17531934211024435","doi-asserted-by":"crossref","unstructured":"Tang JB. Outcomes of flexor tendon repairs and methods of evaluation. In: Tang JB, Amadio PC, Guimberteau JC, Chang J (Eds.)\n                      Tendon surgery of the hand\n                      . Philadelphia, Elsevier, 2012b: 138\u201354.","DOI":"10.1016\/B978-1-4377-2230-7.00022-8"},{"key":"bibr22-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2013.02.007"},{"key":"bibr23-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004416"},{"key":"bibr24-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.cps.2019.02.003"},{"key":"bibr25-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1177\/1753193416641590"},{"key":"bibr26-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/S0363-5023(96)80212-7"},{"key":"bibr27-17531934211024435","unstructured":"Tang JB, Tan J, Xie RG. D. The Nantong experience. In: Tang JB, Amadio PC, Guimberteau JC, Chang J (Eds.)\n                      Tendon surgery of the hand\n                      . Philadelphia, Elsevier, 2012: 247\u201357."},{"key":"bibr28-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.hcl.2017.04.012"},{"key":"bibr29-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1016\/j.aott.2019.07.003"},{"key":"bibr30-17531934211024435","doi-asserted-by":"publisher","DOI":"10.1053\/jhsu.2002.31729"},{"key":"bibr31-17531934211024435","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\/17531934211024435","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17531934211024435","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17531934211024435","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:45:58Z","timestamp":1777502758000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17531934211024435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,18]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1177\/17531934211024435"],"URL":"https:\/\/doi.org\/10.1177\/17531934211024435","relation":{},"ISSN":["1753-1934","2043-6289"],"issn-type":[{"value":"1753-1934","type":"print"},{"value":"2043-6289","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,18]]}}}