Flexion Tendon Repair
The History of Flexor Tendon Injuries
Before 1967, patients who had flexor tendon injuries were resigned to a lifetime of lost function and stiffness of the fingers. Surgical techniques that could restore function were not known before that time. Physical therapists had no idea about the nature of healing flexor tendons, so there was no protocol for preservation of function even the tendons were repaired.
Dr. Harold Kleinert turned the hand surgery world upside down by researching techniques of repair, and engineering physical therapy methods that could allow for continued gliding of tendons and healthy healing. He introduced methods of repair with smaller sutures, and more accurate techniques that would allow tendons to glide within their sheaths, allowing for continued motion of the fingers while they healed. He popularized the concept of dynamic flexion splints that would take tension off of the tendon repairs, and allow for relaxation of the muscles while the patient extended the fingers. The Kleinert splinting method was adopted worldwide, by his name, and the methods of fabrication are practiced worldwide by most hand therapists.
Although many refinements of the technique have been introduced in the past 30 years, the same basic principal now allows the majority of patients worldwide to be able to preserve function of the fingers with good to excellent end results.
Dr. Kleinert continued to contribute to the science of hand and microsurgery, engineering the first double headed microscope to be used for microvascular procedures and replantation of amputated limbs. He and his colleagues performed the first successful double limb replantation in history, and published the largest series of successful limb replantations in history.
He and several of his trainees, including Dr. Joseph Kutz, Dr. Robert Acland, and Dr. Tsu Minh Tsai, established and developed the largest hand and microsurgery center in the world.
One of his trainees, Dr. Warren Breidenbach, performed the first successful hand transplantation in the United States history.
Another one of his trainees, Dr. Maria Siemionow, performed the first successful face transplant in United States history.
Dr. Coleman was fortunate in being one of only 8 doctors selected from the United States to participate in the Kleinert hand fellowship in 1995. He had direct instruction from all of the above mentioned faculty, and was classmates with both Drs. Breidenbach and Siemeonow that year.
Dr.Coleman still uses the same time monitored techniques of repair and therapy, and has continued the tradition of contributing advancements to the science of hand and microsurgery,since starting practice in 1988.
Dr. Coleman was the first surgeon to present the results of 100 fracture repairs of the hand using a microscrew fixation techniques to the American Society of Plastic Surgeons in 1993.
His refinements in the neurovascular flap reconstruction of the fingertip, were presented as a teaching video to the American Society of Reconstructive Microsurgeon’s in 1988.