Primary Repair of Flexor Tendons

Abstract

Primary flexor tendon repair will provide superior functional results at all levels of injury: the forearm, the carpal tunnel, the palm, and distal to the superficialis tendon. Repair of injuries to the flexor tendons in the fibro-osseous tunnel (distal palmar crease to the proximal interphalangeal joint crease) is a controversial subject. Flexor tendon graft is the established and accepted method of treating these injuries. Improved technique in primary tenorrhaphy in the flexor digital sheath has produced results at least equal to those with flexor tendon graft. The technique of primary flexor tenorrhaphy is described. We do not advocate or suggest that primary tendon repair is indicated in most flexor lacerations in the „no man's land“ area unless a specially trained hand surgeon capable of performing primary tenorrhaphy is available. If this surgeon is not available, the wound should be cleansed, the skin sutured, and the patient referred to a specialist for tendon graft. Ill advised attempts at primary tenorrhaphy in this region will result in contracted scarred fingers, which may at best be impossible to restore even with a staged tendon graft procedure.