Step-wise lengthening for delayed repair of avulsion of the flexor pollicis longus

Repair of late avulsion of the flexor pollicis longus tendon at insertion is a rare but difficult problem. A 52-year-old female labourer presented with a 3-month history of inability to flex her right thumb at the interphalangeal joint. Avulsion of the flexor pollicis longus tendon at its insertion was noted on exploration. Because the tendon had contracted and could not be reinserted directly, a technique of step-wise lengthening was used for reinsertion. Two months after operation, the patient resumed her daily activities and went back to work with satisfactory use of her right thumb. This report highlights the possibility of using a simple technique when there is no other alternative.