Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study

Background: There is no concrete evidence to define the optimal mobilization strategy following zone I/II flexor tendon repair. The Saint John Protocol is an active motion regime which utilizes wrist movement to facilitate better clinical outcomes. Our objective was to compare the outcomes of patien...

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Main Authors: See Lok Douglas Ho, Ching San Esther Chow
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Journal of Orthopaedics, Trauma and Rehabilitation
Online Access:https://doi.org/10.1177/22104917241256658
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author See Lok Douglas Ho
Ching San Esther Chow
author_facet See Lok Douglas Ho
Ching San Esther Chow
author_sort See Lok Douglas Ho
collection DOAJ
description Background: There is no concrete evidence to define the optimal mobilization strategy following zone I/II flexor tendon repair. The Saint John Protocol is an active motion regime which utilizes wrist movement to facilitate better clinical outcomes. Our objective was to compare the outcomes of patients who underwent the conventional Kleinert protocol versus the Saint John protocol. Methods: 20 fingers in the Kleinert group and 18 fingers in the Saint John group were included in this retrospective study. Pain score, range of movement, grip strength, and complications were studied at 6 and 12 weeks postoperatively. Results: The Saint John protocol showed significantly less pain at 6 week (0.167 vs 1.08, P  = 0.032) and less flexion contracture at the PIPJ at 6 weeks (3.33 vs 12.25, P  = 0.032). Both groups showed similar rerupture rates (5.5% vs 5%). Conclusions: Saint John protocol demonstrated better clinical outcomes while not sacrificing the integrity of repair.
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spelling doaj-art-951ea27190f74abda95f06684eb6b7762025-08-20T03:08:18ZengSAGE PublishingJournal of Orthopaedics, Trauma and Rehabilitation2210-49252025-06-013210.1177/22104917241256658Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective studySee Lok Douglas HoChing San Esther ChowBackground: There is no concrete evidence to define the optimal mobilization strategy following zone I/II flexor tendon repair. The Saint John Protocol is an active motion regime which utilizes wrist movement to facilitate better clinical outcomes. Our objective was to compare the outcomes of patients who underwent the conventional Kleinert protocol versus the Saint John protocol. Methods: 20 fingers in the Kleinert group and 18 fingers in the Saint John group were included in this retrospective study. Pain score, range of movement, grip strength, and complications were studied at 6 and 12 weeks postoperatively. Results: The Saint John protocol showed significantly less pain at 6 week (0.167 vs 1.08, P  = 0.032) and less flexion contracture at the PIPJ at 6 weeks (3.33 vs 12.25, P  = 0.032). Both groups showed similar rerupture rates (5.5% vs 5%). Conclusions: Saint John protocol demonstrated better clinical outcomes while not sacrificing the integrity of repair.https://doi.org/10.1177/22104917241256658
spellingShingle See Lok Douglas Ho
Ching San Esther Chow
Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study
Journal of Orthopaedics, Trauma and Rehabilitation
title Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study
title_full Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study
title_fullStr Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study
title_full_unstemmed Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study
title_short Comparison of Kleinert versus Saint John protocol in Zone I/II flexor tendon injuries: A retrospective study
title_sort comparison of kleinert versus saint john protocol in zone i ii flexor tendon injuries a retrospective study
url https://doi.org/10.1177/22104917241256658
work_keys_str_mv AT seelokdouglasho comparisonofkleinertversussaintjohnprotocolinzoneiiiflexortendoninjuriesaretrospectivestudy
AT chingsanestherchow comparisonofkleinertversussaintjohnprotocolinzoneiiiflexortendoninjuriesaretrospectivestudy