الفهرس 
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Abstract
Introduction: Better tendon healing and adhesion limitation are 2 major goals of tendon surgery. Methods of primary flexor tendon repair are continuously being modified till today. Generally speaking, ideal operating conditions and atraumatic operative technique must be implemented in the successful repair of flexor tendon laceration in zone II. A strong relation must develop between the surgeon, the patient and the hand therapist. The surgeon needs to spend considerable time explaining the inherent problems to the patient, the likelihood of achieving success, the importance of the rehabilitation protocol. For the sake of better outcomes, primary flexor tendon repair under local infiltration anesthesia using the recently described wide-awake technique was suggested as new competitive approach for flexor tendon repair in zone II. Patients and methods: This study was conducted on comparison between using local anaesthesia on 20 patients versus general anaesthesia on another 20 patients, all of them complaining of cut flexor tendon of finger in zone II with primary tendon repair was done using four strand core sutures after which intraoperative total active movement was applied to detect gapping of the repair and correct it if required so as to get better outcomes and to get ITAROM. Early passive motion technique was chosen for rehabilitation. Follow up of the ROM was done for 12 weeks postoperatively. Original Strickland evaluation system was used for classifying the percent of recovery of TAM. Results described recovery of motion in 85% of cases. Good to excellent results were in 70% of patient with local anaesthesia reported postoperatively, when it was just 45% in patient with general anaesthesia reported postoperatively. CONCLUSION AND RECOMMENDATIONS: This preliminary study assessing the outcomes of primary tendon repair in flexor tendon injuries in zone II using the wide-awake technique demonstrates encouraging results, being satisfactory for both surgeons and patients that makes this new approach a competitive to the other approaches of flexor tendon repair implemented under conventional methods of anesthesia. However, there were a number of limitations to our study such a relatively small number of patients. Improvement of this technique can occur through better and sustained practice, better patient health education to enhance their compliance and future studies that involve large number of patients and compare this new technique to the ordinary primary repair in a randomized controlled trial to get strong evidence supporting this technique.