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Objectives: Despite numerous studies, having the best outcome is challenging after flexor tendon repairs in zone 2. This study were done to test the hypothesis that immediate postoperative active mobilization will achieve similar outcomes to passive mobilization.

Methods: Fifty fingers in 38 patients with flexor tendon repair in zone 2 were enrolled in this trial. The patients randomly assigned in two groups: Early active mobilization and Passive mobilization. They were assessed eight week post operating. Outcomes were defined using “Strickland” and “Buck-Gramko” criteria. The analysis was done according to intention-to-treat principles and with use of mean imputation for missing data.

Results: There were significant difference between groups (P<0.001). The result were 80% excellent and good, 20% fair and no poor in early active motion group, and 40% excellent and good, 44% fair and 16% poor due to Strickland criteria in controlled passive motion group. Mean of total active motion was significantly greater in early active motion group.

Discussion: Actively mobilized tendon underwent intrinsic healing without large gap formation. Increased ultimate range of motion confirmed that early active mobilization can be used after strong repair in zone two.