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The "transverse intraosseous loop technique" (TILT) to re-insert flexor tendons in zone 1
A K Tripathi1, S N J Mee, D L Martin
1Chelsea & Westminster Hospital, Fulham Road, London, UK. aktripathi007@yahoo.co.uk
The Journal of Hand Surgery, European Volume
|January 9, 2009
Summary
The Transverse Intraosseous Loop Technique (TILT) offers a robust method for re-inserting flexor tendons in Zone 1. This surgical approach in 12 patients resulted in full recovery for ten, demonstrating its effectiveness in pediatric cases.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Reconstructive surgery
Background:
- Zone 1 flexor tendon injuries require secure re-insertion to the distal phalanx for functional recovery.
- Existing techniques may present challenges in achieving optimal tension and durability.
Purpose of the Study:
- To describe and evaluate the Transverse Intraosseous Loop Technique (TILT) for flexor profundus tendon re-insertion in Zone 1.
- To assess the efficacy and outcomes of TILT in a pediatric patient cohort.
Main Methods:
- The Transverse Intraosseous Loop Technique (TILT) involves passing an internal suture through the bone and tendon interface at the distal phalanx.
- This technique allows for secure fixation and precise tensioning of the repaired tendon.
Main Results:
- Ten out of 12 patients (83%) treated with TILT achieved full recovery of flexor tendon function.
- Two patients experienced fixed flexion contractures, indicating potential complications.
Conclusions:
- The Transverse Intraosseous Loop Technique (TILT) provides a strong and reliable method for Zone 1 flexor tendon re-insertion.
- TILT is a viable surgical option, particularly suitable for pediatric patients, with a high success rate.
