title: Direct end-to-end repair of flexor pollicis longus tendon lacerations.
abstract: Between 1976 and 1986, 38 consecutive acute isolated flexor pollicis longus lacerations were repaired. This study excluded all replanted or mutilated digits and all lacerations with associated fracture. Average follow-up was 26 months. Tendon rehabilitation was standardized. Range of motion and pinch strength were measured postoperatively. Seventy-four percent (28/38) of the flexor pollicis longus injuries occurred in zone II. Neurovascular injury occurred in 82% of the lacerations, and this correlated with the zone of tendon injury. In 21% of the patients (8/38) both digital nerves and arteries were transected. Postoperative thumb interphalangeal motion averaged 35 degrees and key pinch strength was 81% that of the uninjured thumb. One rupture occurred in a child. Laceration of the flexor pollicis longus is likely to involve damage to neurovascular structures, and repair may be necessary. Direct end-to-end repairs within the pulley system do at least as well as delayed tendon reconstruction and do not require additional procedures.
authors.affiliation: Duke University Medical Center, Durham, NC 27710.
authors.forename: J A
authors.initials: JA
authors.lastname: Nunley
authors.forename: L S
authors.initials: LS
authors.lastname: Levin
authors.forename: D
authors.initials: D
authors.lastname: Devito
authors.forename: R D
authors.initials: RD
authors.lastname: Goldner
authors.forename: J R
authors.initials: JR
authors.lastname: Urbaniak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D016059:Range of Motion, Articular; D013514:Surgical Procedures, Operative / Q000379:methods; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013710:Tendons / Q000503:physiopathology / Q000601:surgery; D013933:Thumb / Q000293:injuries* / Q000601:surgery