FLEXOR-TENDON GRAFTS IN THE FINGERS AND THUMB

An Evaluation of End Results

¹ LOS ANGELES, CALIFORNIA

A sutdy of the end results in a series of flexor-tendon grafts in the fingers and thumb, inserted because of damage to the tendons in the "critical" zone, shows that the influencing factors, in order of importance, are cicatrix from injury or infection, stiffened joints, trophic changes, and damage to more than one digit. Improvement in results has followed the use of Bunnell-type of stainless-steel wire sutures in place of silk, combined with meticulous excision of scar and thickened sheath tissue. The use of the palmaris longus tendon as a graft has given better results than use of other tendons. In the thumb, a graft from the musculotendinous origin to the insertion is preferred. It has been shown that, under ideal conditions, the results of digital flexor-tendon grafts are as follows: In 25 per cent. of the cases flexion is complete, so that the pulp of the finger reaches the distal crease of the palm; in 50 per cent., the pulp reaches to within one-half inch of the distal crease of the palm.

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