Flexor Pollicis Tendon Reconstruction With Allograft Tendon After Rupture: Technique and Case Series

Division or rupture of the flexor pollicis longus (FPL) tendon can occur secondary to direct injury, laceration, or attritional rupture. Attritional rupture is particularly common in the setting volar plate fixation of a distal radius fracture. FPL tendon discontinuity can be restored through either primary repair or reconstruction. Primary repair can be challenging if not done within the first few days after injury secondary to contraction of the FPL muscle with retraction of the proximal tendon. Repair in this environment can lead to tension across the repair site as well as necessary flexion of the interphalangeal joint to accommodate primary repair. In the setting of attritional rupture, the proximal and distal ends are typically not viable for direct repair. We present our preferred technique for restoration of the FPL tendon, which is reconstruction with an allograft tendon.