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Updated: Aug 16, 2026
Murine Flexor Tendon Injury and Repair Surgery
Published on: September 19, 2016
Repair of the flexor pollicis longus tendon in children
F Fitoussi1, K Mazda, J M Frajman
1Robert Debré Hospital, Paris, France.
Insights
Primary flexor pollicis longus tendon repairs in children yield good results, though some experience decreased thumb flexion. A new assessment method is proposed for pediatric patients.
Area of Science:
- Pediatric Orthopedics
- Hand Surgery
- Reconstructive Surgery
Background:
- Flexor pollicis longus (FPL) tendon injuries in children require effective surgical repair.
- Assessing functional recovery in pediatric patients presents unique challenges.
Purpose of the Study:
- To evaluate the outcomes of primary FPL tendon repairs in children.
- To propose a novel assessment method for FPL function recovery in pediatric populations.
Main Methods:
- Retrospective study of 16 pediatric patients (<15 years) undergoing primary FPL repair within 24 hours.
- Exclusion criteria included neurovascular injuries, crush injuries, skin loss, or fractures.
- Modified Kessler technique used for repairs; outcomes assessed using Buck-Gramko and Tubiana criteria.
Main Results:
- Excellent or good outcomes in 15 of 16 patients, with one secondary tendon rupture.
- One-third of patients showed a significant decrease (>30 degrees) in active interphalangeal flexion compared to the uninjured thumb.
- Postoperative immobilization with a short splint negatively impacted outcomes.
Conclusions:
- Primary FPL repair in children generally yields favorable results.
- A new, child-specific functional assessment method for FPL tendon recovery is suggested.
- Short splint immobilization may hinder functional recovery in pediatric FPL repairs.
Abstract:
This is a retrospective study of primary repairs of flexor pollicis longus in 16 children under 15 years of age. Patients with injuries to the median or ulnar nerve at the wrist, crush injuries, skin loss or fracture were excluded. Repairs were carried out within 24 hours using a modified Kessler technique. The mean follow-up was for two years. The final results were evaluated using the criteria of Buck-Gramko and Tubiana. They were good or excellent in all except one patient who had a secondary tendon rupture. When compared with the non-injured thumb, however, there was a significant decrease in active interphalangeal flexion (> 30 degrees) in one-third of cases. A new method of assessment is proposed for the recovery of function of the flexor pollicis tendon which is more suitable for children. Postoperative immobilisation using a short splint had a negative effect on outcome. The zone of injury, an early mobilisation programme or concurrent injury to the digital nerve had no significant effect on the final result.
