REHABILITASI MEDIK PADA CEDERA TENDON FLEKSOR TANGAN

Abstract

Tendons are fibrous connective tissues, structurally analogous to cords, that effect the mechanical linkage between skeletal muscles and bone. The muscular tissue transitions into tendinous tissue, subsequently achieving direct osseous insertion. Upon muscular contraction, the tendon exerts a traction force on the bone, thereby inducing articular motion (e.g., at the digital interphalangeal joints). Tendon injuries are specifically characterized as lacerations, avulsions, or perforating wounds affecting either the flexor or extensor tendons of the manus. While isolated tendon injuries can occur, they are frequently concomitant with osseous fractures, neuropathic deficits, and/or soft tissue trauma. The specific mechanisms of injury significantly influence the prognosis. Blunt force trauma or impact injuries are demonstrably associated with a higher incidence of scar tissue formation. Both partial and complete disruptions of flexor tendons necessitate surgical repair to mitigate persistent functional deformity. Such repairs mandate meticulous surgical exploration, as the proximal segment of the transected tendon is consistently subject to proximal retraction, requiring advanced surgical skill for successful re-approximation. The primary objectives of medical rehabilitation following flexor tendon repair of the hand are multifaceted: to restore normal tendon excursion and gliding mechanics, prevent post-repair tendon rupture, avert flexion contractures, accelerate the tendon healing cascade, re-establish active and passive joint range of motion, maintain physiologic range of motion in unaffected articulations, and ultimately restore pre-morbid functional capacity. Post-repair rehabilitation protocols for flexor tendon injuries can be implemented via three primary methodologies: complete immobilization, early passive mobilization, and/or early active mobilization. The surgical repair and subsequent rehabilitation of hand flexor tendon injuries present considerable challenges, necessitating a multidisciplinary collaborative approach. This team typically comprises physicians, physiotherapists, orthotists/prosthetists, and occupational therapists, with a specialized emphasis on hand therapy.