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Related Experiment Video

Updated: Apr 21, 2026

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects
06:36

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects

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Single-Stage Flexor Tendon Reconstruction Using Tendon Grafting Versus Turnover Tendon Split-Lengthening Technique.

Eleni Karagergou1, Maria Baxevanou1, Anastasia Moysiadou1

  • 1A' Orthopaedic Department, Aristotle University of Thessaloniki, Papanikolaou Hospital, Thessaloniki, Greece.

Journal of Hand Surgery Global Online
|April 20, 2026
PubMed
Summary

Single-stage flexor tendon reconstruction using tendon grafting or turnover split-lengthening offers similar functional outcomes for patients with flexor tendon injuries. Both methods have high complication rates, highlighting challenges in secondary tendon repair.

Keywords:
Tendon gapTendon graftTendon injuryTendon lengtheningTendon reconstruction

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Reconstructive Surgery

Background:

  • Flexor tendon injuries often require reconstruction when primary repair is not feasible.
  • Single-stage reconstruction aims to restore function efficiently.
  • Traditional tendon grafting and turnover split-lengthening are two techniques for secondary flexor tendon reconstruction.

Purpose of the Study:

  • To compare long-term functional outcomes and complication rates of single-stage flexor tendon reconstruction.
  • To evaluate traditional tendon grafting versus the turnover split-lengthening technique.
  • To assess outcomes in patients with flexor tendon injuries unsuitable for primary repair.

Main Methods:

  • Retrospective review of 14 patients undergoing single-stage flexor tendon reconstruction (2014-2022).
  • Comparison of palmaris longus tendon grafts (n=7) versus turnover split-lengthening (n=7).
  • Assessment of total active range of motion (AROM), grip strength, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores.

Main Results:

  • No significant differences in AROM, grip strength, or QuickDASH scores between the two techniques.
  • Mean AROM was 67.6%, mean grip strength was 90.7% of the contralateral hand, mean QuickDASH score was 2.9.
  • Complications occurred in 50% of patients, irrespective of reconstruction method, often correlating with poorer functional results.

Conclusions:

  • Single-stage flexor tendon reconstruction using either tendon grafting or turnover split-lengthening yields comparable functional results.
  • The turnover technique is a valuable alternative, especially when palmaris longus is unavailable.
  • Both methods are associated with significant complication rates, underscoring the complexity of secondary tendon reconstruction.