الفهرس 
Detailed Anatomy of the Flexor Tendons and Pulley System with Focus on Zone IIOnly 14 pages are availabe for public view
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Abstract
Background: Flexor tendon injuries especially zone II are a challenging problem for both surgeons and patients as they need careful post-operative early physiotherapy to decrease adhesions and improve gliding which carry risk of early tendon rupture. Many drugs were tested for their role in decreasing paratendinous adhesions and enhance clinical outcome, this study by ultrasound examination test effect of intraoperative addition of heparin in limiting paratendinous adhesions and improving clinical outcome.
Aim of the Work: to evaluate the effect of intraoperative heparin addition in preventing postoperative adhesions and on clinical outcome.
Patients and Methods: This clinical trial study included 21 patients with 31 surgically repaired zone II flexor digitorum profundus tendons. The 21 Patients were divided randomly into two groups, group A (study group) with heparin injection during surgical repair and group B (control group) without heparin injection, with a total number of eleven patients in group I and ten patients in group II.
Results: There was no statistically significant difference between the two groups in tendon margins, gliding or granulation tissue severity, which can support why it does not affect clinical outcome. There was no statistically significant relation between the heparin injection and tenosynovitis although heparin is known for its anti-inflammatory effect. Tendon re rupture was more presented in heparin injected group yet not of statistical significance.
Conclusion: The intraoperative heparin injection at repair site didn’t show any significance in enhancing clinical outcome or in limiting paratendinous adhesions. Although it wasn’t of statistical significant but tendon re-rupture was more seen incases managed with heparin injection group so heparin injection is not recommended in treatment such cases yet further investigations are needed.