A surgeon's historical perspective: Dr. Leonard Furlow on the early years of human composite flexor tendon allografts

Abstract

"I think that probably convenience is what did in the flexor mechanism allograft," Dr. Leonard Furlow explained in response to why tendon allografts in the 1960s were overshadowed by the Hunter rod, which is still routinely used for flexor tendon reconstruction today. At 83 years old, Dr. Furlow had graciously made the trip from his home in Gainesville, FL up to Charlottesville, VA for a special interview with the Department of Plastic Surgery at the University of Virginia. Furlow is perhaps better known for developing the double-opposing Z-plasty for cleft palate repair, but his interest in hand surgery led to a year in Chapel Hill, NC where he trained with the creator of the flexor mechanism allograft, Dr. Erle E. Peacock, Jr. Through innovative experimental work on flexor tendon reconstruction, Peacock had pioneered the use of fresh composite tendon allografts, which transplant the unscarred synovial space between the tendon and its sheath such that scar formation only occurs outside the sheath. Inspired by our recent research interest in this subject, we asked Dr. Furlow to reflect on his experience with the tendon allograft in the 1960s with the late Dr. Peacock. The picture he painted was of a simple, elegant, and astonishingly successful solution for flexor tendon reconstruction that suffered from a lack of practicality at the time.