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Abstract
The ability to restore function to a digit following flexor tendon interruption has improved considerably in recent years thanks to aplethora of laboratory and clinical investigations. Although the results of improved suture techniques and post-repair mobilization methods have been encouraging, they are still short of the consistent recovery of nearly full function that hand surgeons have long strived for. The methods described here are certainly not the final or, perhaps, even the best current methods for flexor tendon repair or post-repair rehabilitation. They are simply a personal ”snapshot in time” of the most scientifically supportable and clinically practical methods.
There will continue to be modifications of current methods or entirely new approaches to this difficult problem as additional scientific studies support those changes. We already recognize that the ”ideal”tendon suture technique does not yet exist, and we should strive to create a method that will ensure equal tension on all suture strands, reduce the number of knots, and if possible, eliminate knots from the repair site. In addition, we need to improve the techniques that ensure dorsal placement of the sutures and minimize the bulk of the repair site and the coefficient of friction produced by the repair as it glides under the annular pulleys of the sheath.
Internal splinting methods and stronger suture technique will undoubtedly be developed and will permit even more aggressive postrepair motion protocols. We are, however, very encouraged by the markedly improved results that are currently being achieved with the methods described in this chapter. There will surely continue to be an explosion of laboratory and clinical information leading to repair and motion protocols that will return predictably excellent results in this difficult area.