Tendon Repair and Reconstruction

Abstract

Exciting new developments in flexor tendon repair made possible by the tourniquet-free, sedation-free, pain-free wide-awake approach are covered in detail in this chapter. This approach permits minimal sheath destruction, as flexor tendons are repaired through small transverse sheathotomy incisions. Active intraoperative flexion by the patient allows surgical adjustments to be made before the skin is closed to ensure that there is no gapping of the flexor repair and that the repair glides nicely in the sheath to get an optimal range of motion.. Intraoperative patient teaching by the surgeon and the hand therapist present allows the patient to practice the postoperative movement regime in a pain-free comfortable environment. Risks and inconveniences of general anesthesia are avoided in almost all patients. Very functional differential gliding, split-its allow patients who have undergone dorsal hand extensor tendon repair to return to work 2-3 days after surgery and use the fingers of their operated hand with very little risk of tendon rupture.