Flexor Tendon Reconstruction

Abstract

Improved methods of primary flexor tendon repair have diminished the need for tendon reconstruction. Nonetheless, reconstruction remains an option for neglected digital flexor tendon lacerations and for failed flexor tendon repair in patients who have a supple, sensate finger and who are able to comply with an extensive rehabilitation program. Preoperative and intraoperative findings dictate whether a one-stage or two-stage procedure is appropriate. The first stage of a two-stage procedure involves insertion of a silicone rod-and-pulley reconstruction; at the second stage, the rod is replaced with a tendon graft. Some improvements have been made in surgical techniques as well as rehabilitation protocols. Future techniques, such as tissue engineering, may provide better functional results.