Flexor tendon grafting to the hand: An assessment of the intrasynovial donor tendon - A preliminary single-cohort study

We report the results of a pilot study using intrasynovial donor tendons fo r flexor tendon reconstruction in 8 patients (10 digits) at a mean follow-u p time of 3.8 years for neglected or failed primary repair of zone 2 lacera tions and for neglected flexor digitorum profundus avulsions. The flexor di gitorum longus to the second toe was used as the donor tendon graft. Four p atients (4 digits) underwent single-stage reconstruction and 4 patients (6 digits) had multistage reconstruction. The overall patient satisfaction usi ng a standardized visual analog reporting scale was excellent. There was 1 excellent, 1 good, 1 fair, and 1 poor result in the single-stage reconstruc tion group, including 1 repair site rupture and 1 digit requiring tenolysis . In the multistage reconstruction group there was 1 excellent, 3 good, 1 f air, and no poor results, including 1 digit requiring tenolysis. One patien t was lost to follow-up. There was no donor site morbidity. The average act ive motion recovery was 64% and 56% for single-stage and multistage reconst ructions, respectively, and was 73% overall for single digit reconstruction s. The results of this pilot study suggest that intrasynovial tendon grafti ng may offer an improved alternative for tendon grafting to the synovial sp aces of the digit. (J Hand Surg 2000; 25A:721-730. Copyright (C) 2000 by th e American Society for Surgery of the Hand).