SECONDARY RECONSTRUCTION OF FLEXOR TENDONS

Secondary flexor tendon repair has lost its dominant position since CLAUDE VERDAN and other pioneers demonstrated, that primary tendon suture within the former "no man's land" is even more successful than secondary tendon grafting. Secondary reconstruction may concern delayed direct tenorrhaphy, one or two staged, short or long tendon grafts, pedicled tendon transplants, pulley reconstruction, tenodesis and tendon transfer. Secondary repair may be indicated for overlooked tendon injuries, for infected wounds, traumatic or septic tendon defects, for rheumatic ruptures and finally for failed primary repair of tenolysis. The indications and techniques of the different procedures are demonstrated and discussed.