Delayed repair of flexor profundus tendon in the palm (zone 3) with superficialis transfer

Transfer of a flexor superficialis tendon was done in an attempt to restore flexor profundus function, as a secondary procedure, in the palm (zone 3) in 16 hands. These were cases in which direct repair was not possible. Eight patients achieved a total active motion (TAM) above 200 degrees and two more were above 180. Of those eight with TAM above 200 degrees four required a secondary tenolysis to improve to that level. Transfers in six patients were regarded as failures. Failures were associated with a poor tendon bed and noncompliant patients. This is a procedure that has limited indication in a cooperative patient with a good tendon bed who reports late with both flexor tendons cut in zone 3.