Plastic surgery Digital flexor tendon repair

Digital Flexor Tendon Repair

Objective

In case of tear of flexon tendons:

•   Repair of severed ends of a tendon caused by injury.

Position

Supine hand on hand rest.

Anesthesia

General.

Procedure

   1.  Esmarch bandage.

   2.  Midlateral digital incisions are often employed.

   3.  Care is taken to avoid injury to the neurovascular bundle.

   4.  Pulleys are preserved when possible.

   5.  The proximal tendon end is retrieved.

   6.  If length is not sufficient a graft (e.g. from the palmaris longus tendon) is prepared.

   7.  The tendon ends are approximated.

   8.  If the tendon insertion is involved, suture to the bone may be facilitated using fine drill holes.

   9.  The suture fixing the tendon graft to the insertion is tied over a button on the dorsum of the distal phalanx to prevent soft tissue necrosis.

10.  The wound is closed.

11.  A splint is applied.

Instruments

•   Limited plastic procedure set 

•   Power drill and fine drill points 

•   Microinstrumentation (Neddle holder, scissors, forceps) 

•   Basin set 

•   Sheet wadding 

•   Esmarch bandage 

•   Tube (or impervious) stockinette 

•   Blades (2) No. 15 

•   Bulb syringe 

•   Marking pen 

•   Straight Keith needle and button 

•   Magnification

Any questions be sent to drmmkapur@gmail.com

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