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  • Title: [Acute flexor tendon surgery].
    Author: Stephan C, Saalabian A, van Schoonhoven J, Prommersberger KJ.
    Journal: Oper Orthop Traumatol; 2008 Mar; 20(1):44-54. PubMed ID: 18338118.
    Abstract:
    OBJECTIVE: Flexor tendon repair by direct suture, providing tendon function and mechanical properties and allowing postoperative active extension and flexion. INDICATIONS: Flexor tendon laceration in all zones, when primary healing and a good functional outcome can be expected. CONTRAINDICATIONS: Florid and chronic infection. Lack of skill, instruments, or manpower. Tension-free suture is not feasible. Severe soft-tissue problems. Mantero suture in case of coexistent artery injury. SURGICAL TECHNIQUE: Hand surgical incisions and approach to the tendon. Opening of the tendon sheath in the region of oblique pulley. A four-strand core suture consisting of two locked two-strand sutures and a circumferential epitendon cross-stitch suture are performed. Lacerations in zone I with a tendon stump shorter than 1 cm require a Mantero suture and avulsions require a pull-out suture technique. POSTOPERATIVE MANAGEMENT: Active flexion and active extension in a dorsal wrist cast. RESULTS: The clinical outcome studies after repair of zone II flexor tendon injuries using a multiple-strand suture technique describe 69-96% excellent and good results.
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