The treatment of flexor tendon lesions of the fingers

In this study we checked the functional results of flexor tendon sutures in a group of 50 non-selected patients, observed during 4 to 5 years. The functional results of our 84 flexor tendon sutures speak well for primary suturing with favourable wound conditions. This applies to all zones, even to Zone Ii where a primary repair does not exclude the possibility of a successful secondary tendon graft using Hunter's method. In case of a cut of the profundus and superficialis tendons in Zones II and III, the question of whether both tendons or just the profundus should be repaired, will be answered by the levels of the cuts. In Zone II the superficialis tendon is better left untouched, as a resection produces less favourable results owing to the traumatization of the tissues. For the pollicis longus a critical localization of the tendon sheath, distal to the metacarpophalangeal joint, may be an indication for a tendon transfer or transplantation. The minimally traumatizing technique and adequate postoperative rehabilitation and follow-up do explain the good results, even in Zone II where they reached a 66% rate.