Two-stage grafting of flexor tendons: results after mobilisation by controlled early active movement

We present the results of two-stage flexor tendon grafting to the hand followed by early active mobilisation. Twenty-six digits from 22 patients were assessed over a 10-year period between 1991 and 2001. Using the LaSalle and Strickland assessment for surgical outcome, we found that 20 digits (77%) achieved excellent or good results. Two ruptured (8%) and one developed adhesions (4%). We think that our results are achieved through meticulous attention to surgical technique with the use of mid-lateral incisions for surgical access, strong bony fixation of the graft that allows a good interface between tendon and distal phalanx, and a closely supervised early active mobilisation regimen after the repair.