Clinical use of a combined grasping and locking core suture technique for flexor tendon repair in zone II

Abstract

Previous authors have used either a grasping or a locking technique for flexor tendon repair in zone II. A combined (grasping and locking) 10-strand repair was used by the author in 22 adults (n = 28 fingers) with lacerations of both flexor tendons in zone II. The combined repair is known to be strong (mean tensile strength of 164 N), and the technique was used in selected cases who were thought to be at higher risk of rupture either because of excessive digital oedema (in early tendon repairs) or because of tendon retraction (in late primary tendon repairs). The 10-strand repair was bulky and, hence, only the profundus tendon was repaired; and “venting” of the pulley system was done proximal to the repair site as recommended by other authors. Supervised early active mobilisation was done immediately after the operation. At final follow-up, the outcome was calculated using the original Strickland-Glogovac grading system. There were no ruptures and the final outcome was considered excellent in 19 patients (n = 25 fingers), good in two patients (n = 2 fingers), and fair in the remaining patient (n = 1 finger). It was concluded that the bulky 10-strand repair may be used for zone II finger flexor tendon lacerations as long as a profundus–(?) only repair and “venting” of the pulley system are performed.