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Abstract The main objective of the study is to determine the difference between the effect of early dynamic flexion protocol and place and hold on flexor tendon excursion and adhesion after repair. Subjects and methods: 30 participants who underwent zone II flexor tendon primary modified Kessler repair. (23 males and 7 females with age ranged from 18 to 50) the participants were divided into both groups. The participants were selected from the Cairo University Hospital, the Department of Physical Therapy. group (A) composed of 15 patients who received place and hold protocol 3rd day post-operative and group (B) who received early active dynamic protocol 3rd day post-surgical repair. patients in each group received the treatments (3sessions/week) from the 3rd day post-operative till the 6th week post-operative. All patients were assessed by ultrasound to detect tendon excursion at 3rd and 6th weeks postsurgical repair.Results: There was a significant increase in the tendon excursion at 6 weeks compared with that at 3 weeks post treatment in the group A and B and there was no significant difference in adjusted mean of tendon excursion at 6 weeks between both group. Conclusion: The present study demonstrated that both active protocol affected the excursion of the flexor tendon zone II after surgical repair |