Minimal-incision tenorrhaphy in flexor tendon injury

굴곡건 손상에서 최소절개 건 봉합술

  • Jang, Ju Yun (Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine) ;
  • Oh, Sang Ah (Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine) ;
  • Kang, Dong Hee (Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine) ;
  • Lee, Chi Ho (Department of Plastic and Reconstructive Surgery, Dankook University College of Medicine)
  • 장주윤 (단국대학교 의과대학 성형외과학교실) ;
  • 오상아 (단국대학교 의과대학 성형외과학교실) ;
  • 강동희 (단국대학교 의과대학 성형외과학교실) ;
  • 이치호 (단국대학교 의과대학 성형외과학교실)
  • Published : 2009.07.15

Abstract

Purpose: To retrieve the retracted flexor tendon, additional incision and wide dissection are conventionally required. We introduce minimal - incision tenorrhaphy using 1 cm - length incision and minimal dissection. Methods: Transverse incision about 1 cm - length is made over the level of retracted tendon. Nelaton's catheter is advanced into tendon sheath from distal primary laceration wound to emerge proximally through the incisional wound. Catheter is sutured to proximal tendon in end - to - end fashion. By gently pulling the catheter, retracted tendon is delivered to distal wound. Tenorrhaphy with core suture and epitendinous suture is then carried out. Results: This retrieving technique provides minimal incision, minimal dissection, minimal bleeding, minimal injury to tendon end, and shorter operation time with preservation of vincula tendinum and pulley system. Conclusion: In case of flexor tendon rupture with retraction, this operative method is believed to allow reliable and effective tenorrhaphy and excellent postoperative outcomes.

Keywords

References

  1. Lehfeldt M, Ray E, Sherman R: MOC-PS(SM)cmE article: treatment of flexor tendon laceration. Plast Reconstr Surg 121: 1, 2008
  2. Sourmelis SG, McGrouther DA: Retrieval of the retracted flexor tendon. J Hand Surg 12: 109, 1987 https://doi.org/10.1016/0266-7681(87)90071-4
  3. Adeniran A, Barbar AZ: A relatively atraumatic method of retrieving retracted digital flexor tendons. J Hand Surg 22: 122, 1997 https://doi.org/10.1016/S0266-7681(97)80037-X
  4. Wharton EM, Rawlins JM, Stanley PR: Flexor tendon retrieval-another way. J Hand Surg Eur Vol 32: 518, 2007 https://doi.org/10.1016/j.jhse.2007.03.011