[Results after staged reconstruction of the flexor pollicis longus tendon]

The objective of this study was to evaluate results after staged reconstruction of the flexor pollicis longus tendon (FPL) and to compare the results with literature. The advantages and disadvantages of staged reconstruction with a total duration of therapy of four months are discussed and theoretically compared with the simple and fast alternative, the arthrodesis of the interphalangeal joint (IP) of the thumb. The results of 22 patients from 1993 until 2000, 16 of which could be re-examined, are presented. Clinical parameters (grip strength and motion) were evaluated as well as the DASH score. In all cases a long graft to the forearm was used. The second operation usually followed eight weeks after the first operation. The results show a sufficient function in 75 % of the cases (scoring system of Buck-Gramcko et al.), which is paralleled by a median of 11 in the DASH score. The study shows that staged reconstruction can produce satisfactory results even in thumbs. The results are influenced negatively by persistent flexion contractures, insufficiency of annular pulleys and ailments after algodystrophy, which can be seen as indicator of the severity of the initial injury.