Wide-awake flexor tendon repair and early tendon mobilization in zones 1 and 2
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Updated: May 11, 2026

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
Published on: December 10, 2021
Donald H Lalonde1, Alison L Martin
1Department of Surgery, Saint John Regional Hospital, Dalhousie University, 400 University Avenue, Saint John NB E2L 4L4, Canada. drdonlalonde@nb.aibn.com
Abstract:
The wide-awake approach to flexor tendon repair has decreased our rupture and tenolysis rates and permitted us to get consistently good results in cooperative patients. The wide-awake surgery allows the repair of gaps of the surgical repair site revealed with intraoperative active movement testing of the repair We are now doing midrange active movement after primary tendon repair. After tenolysis, full-range active motion is possible even before skin closure. We no longer perform flexor tendon repair with the tourniquet, sedation, and muscle paralysis of general or block (Bier or axillary) anesthesia.

