gms | German Medical Science

Objectives/Interrogation: Tendon grafting to the digital sheaths of the hand sometimes dose not good results. One factor affecting the results may that the grafts are usually from extrasynovial tendons such as palmaris longs or plantaris tendon. The aim of this study was analysis the outcomes intrasynovial tendon grafting harvested from toe flexor for secondary flexor tendon reconstruction.

Methods: From 2010 to 2015, I treated 7 patients. The intrasynovial tendon harvested from the second or third toe. Three digits were two staged tendon reconstructions. The tendons were sutured into the appropriate FDP tendon proximally using a Pulvertaft weave; the distal end of the graft was direct suture to the base of the distal phalanx. The operations were performed by only one surgeon. Postoperative rehabilitation was active flexion and extension exercise with dorsal extension block splint.

Results and Conclusions: The finger TAM was 92.0% (range: 78.5-100%), the recovery rate was 94.2% (80.6-100%). The tenolysis did not underwent. One patient failed at the proximal suture site in the palm associated with infection at 3 weeks. Three months later, I transferred the ring flexor tendon to the proximal stump of the grafted tendon in the palm. All patients had residual limited flexion of the donor toe. However, gate was apparently normal.

This technique is feasible and gives a good result.