Anatomical repair of zone 1 flexor tendon injuries.
BACKGROUND
Repair and rehabilitation of the flexor digitorum profundus tendon in zone I may be demanding. The aim of the authors' study was to assess a new technique for reinsertion of the distal flexor digitorum profundus tendon.


METHODS
The authors' series consisted of 18 patients who required primary (n = 10) or secondary (n = 8) repair of the flexor digitorum profundus tendon in zone I. A half-Bruner incision was extended into the distal volar skin to expose the insertion site. Two drill holes were made through the base of the distal phalanx obliquely from the insertion of the profundus tendon in a dorsolateral direction. A modified Kessler suture was passed through the tendon and then through these holes and tied anteriorly, providing transosseous, internal fixation. Range of movement was assessed according to Moiemen's categories.


RESULTS
Fourteen patients had excellent or good results, two patients had fair results, and one patient had a poor result. One patient failed to complete physiotherapy and was lost to follow-up. No tendon rupture was documented during a mean follow-up period of 8 months.


CONCLUSIONS
The authors' technique anchors the flexor digitorum profundus tendon or the graft in an anatomical position on the distal phalanx, without the need for external sutures or additional incisions. Furthermore, this is accomplished with minimal morbidity to the surrounding highly specialized tissue. The authors' results compare favorably with those of other techniques in the literature.
Teo
T C
TC
East Grinstead, United Kingdom From the Queen Victoria Hospital.
Dionyssiou
Dimitrios
D
Armenio
Andrea
A
Ng
Darren
D
Skillman
Joanna
J
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005385:Fingers / Q000033:anatomy & histology* / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D013536:Suture Techniques; D013708:Tendon Injuries / Q000473:pathology* / Q000601:surgery*; D055815:Young Adult