Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence

As primary repair of divided flexor tendons becomes more common, secondary tendon surgery becomes largely that of the complications of primary repair, namely ruptured and adherent repairs. These occur with an incidence of each in most reported series world-wide of around 5%, with these problems havi...

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Main Authors: David Elliot, Thomas Giesen
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2013-01-01
Series:Indian Journal of Plastic Surgery
Subjects:
Online Access:http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=3;spage=458;epage=471;aulast=Elliot
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author David Elliot
Thomas Giesen
author_facet David Elliot
Thomas Giesen
author_sort David Elliot
collection DOAJ
description As primary repair of divided flexor tendons becomes more common, secondary tendon surgery becomes largely that of the complications of primary repair, namely ruptured and adherent repairs. These occur with an incidence of each in most reported series world-wide of around 5%, with these problems having changed little in the last two decades, despite strengthening our suture repairs. Where the primary referral service is less well-developed, and as a more occasional occurrence where primary treatment is the routine, the surgeon faces different problems. Patients arrive at a hand unit variable, but longer, times after the primary insult, having had no, or bad, previous treatment. Sometimes the situation is the same, viz. an extended finger with no active flexion, but now no longer amenable to primary repair. Frequently, it is much more complex as a result of injuries to the other tissues of the digit and, also, as a result of the unaided healing process within the digit in the presence of an inactive flexor system. We present our experience in dealing with ruptured repairs, tethered repairs and pulley incompetence.
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spelling doaj-art-918e1ce134894f49b7398ebedfdb070f2025-08-20T03:20:36ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2013-01-0146345847110.4103/0970-0358.121931Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetenceDavid ElliotThomas GiesenAs primary repair of divided flexor tendons becomes more common, secondary tendon surgery becomes largely that of the complications of primary repair, namely ruptured and adherent repairs. These occur with an incidence of each in most reported series world-wide of around 5%, with these problems having changed little in the last two decades, despite strengthening our suture repairs. Where the primary referral service is less well-developed, and as a more occasional occurrence where primary treatment is the routine, the surgeon faces different problems. Patients arrive at a hand unit variable, but longer, times after the primary insult, having had no, or bad, previous treatment. Sometimes the situation is the same, viz. an extended finger with no active flexion, but now no longer amenable to primary repair. Frequently, it is much more complex as a result of injuries to the other tissues of the digit and, also, as a result of the unaided healing process within the digit in the presence of an inactive flexor system. We present our experience in dealing with ruptured repairs, tethered repairs and pulley incompetence.http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=3;spage=458;epage=471;aulast=ElliotFlexor tendon injuryflexor tendon reconstructionflexor tendon pulley reconstructionsecondary flexor tendon repairtenolysis
spellingShingle David Elliot
Thomas Giesen
Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence
Indian Journal of Plastic Surgery
Flexor tendon injury
flexor tendon reconstruction
flexor tendon pulley reconstruction
secondary flexor tendon repair
tenolysis
title Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence
title_full Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence
title_fullStr Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence
title_full_unstemmed Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence
title_short Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence
title_sort treatment of unfavourable results of flexor tendon surgery ruptured repairs tethered repairs and pulley incompetence
topic Flexor tendon injury
flexor tendon reconstruction
flexor tendon pulley reconstruction
secondary flexor tendon repair
tenolysis
url http://www.ijps.org/article.asp?issn=0970-0358;year=2013;volume=46;issue=3;spage=458;epage=471;aulast=Elliot
work_keys_str_mv AT davidelliot treatmentofunfavourableresultsofflexortendonsurgeryrupturedrepairstetheredrepairsandpulleyincompetence
AT thomasgiesen treatmentofunfavourableresultsofflexortendonsurgeryrupturedrepairstetheredrepairsandpulleyincompetence