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Primary Repair of Flexor Tendons—A Summary*
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CLAUDE VERDAN
keep the syndrome of the quadriga in mind and to loosen the tendinous heads proximally by cutting them as high as possible and leaving them to their fate. Flexion of the middle phalanx will be ensured by the two flaps of the superficial flexor and flexion of the basal phalanx by the interosseus muscles and the lumbricals. 9 Avenue de la Gare Lausanne, Switzerland
Primary Repair of Flexor Tendons-A Summary* CLAUDE VERDAN, M.D.
THE course hitherto adopted of performing tendinous grafts instead of urgently repairing flexor cuts in Bunnell's "no man's land" is too rigorous. It is only justified for those having no experience in hand surgery or when general or local conditions do not allow of immediate repair. For clean, fresh wounds, specialists capable of performing tendinous grafts correctly are "a fortiori" qualified to effect primary sutures. The technique proposed consists in excising the sublimis, suturing the profundus accurately with fine epitendinous stitches, resecting the sheath at the point of affrontment, and fixing the ends with two transverse stainless steel pins preventing tension on that delicate suture comparable to that of a nerve. Should adherences hinder gliding, a secondary tenolysis procures functional results often better than those obtained by tendinous grafts. For multiple simultaneous flexor cuts on several fingers, primary repair is even more justified than for one a:lone. * The original manuscript has been submitted to The Journal of Bone and Joint Surgery for publication.
CLAUDE VERDAN
keep the syndrome of the quadriga in mind and to loosen the tendinous heads proximally by cutting them as high as possible and leaving them to their fate. Flexion of the middle phalanx will be ensured by the two flaps of the superficial flexor and flexion of the basal phalanx by the interosseus muscles and the lumbricals. 9 Avenue de la Gare Lausanne, Switzerland
Primary Repair of Flexor Tendons-A Summary* CLAUDE VERDAN, M.D.
THE course hitherto adopted of performing tendinous grafts instead of urgently repairing flexor cuts in Bunnell's "no man's land" is too rigorous. It is only justified for those having no experience in hand surgery or when general or local conditions do not allow of immediate repair. For clean, fresh wounds, specialists capable of performing tendinous grafts correctly are "a fortiori" qualified to effect primary sutures. The technique proposed consists in excising the sublimis, suturing the profundus accurately with fine epitendinous stitches, resecting the sheath at the point of affrontment, and fixing the ends with two transverse stainless steel pins preventing tension on that delicate suture comparable to that of a nerve. Should adherences hinder gliding, a secondary tenolysis procures functional results often better than those obtained by tendinous grafts. For multiple simultaneous flexor cuts on several fingers, primary repair is even more justified than for one a:lone. * The original manuscript has been submitted to The Journal of Bone and Joint Surgery for publication.