New Technique of Flexor Tendon Repair with Endoscopic Exploration

ABSTRACT

Repair of injured tendon especially is still a difficult problem in hand surgery. The challenge is to restore the gliding mechanism of the tendon. Despite increasing knowledge of tendon healing and subsequently better postoperative result, the problem formation of adhesion between the tendon and its direct surroundings remains. It is now agreed that primary repair of both flexor tendon is the treatment of choice with preservation and resto-ration of the tendon sheath. The flexor tendon sheath plays an important role in flexor nutrition, especially for the volar part of the tendon, by secreting the synovial fluid. Although data to data are indications that it will lead to fewer adhesions. Tendon sheath are sometimes restored by autologous graft. It is excellent management that the tendon sheath and pulley system are restored during tendon repair. The method of minimal injury to tendon sheath and pulley is better than restoration of that. The exploration of divided tendon through wound margin with endoscope minimizes sheath and pulley injuries. The blunt extraction of divided tendon from invisible wound site is a risky method for exploration of tendon. This endoscopic method is less traumatic, causes less pain, and requires a minimal incision. And the patient with endoscopic tenorrhaphy can exercise immediately because less operation site discomport and can be discharged early. The new tenorrhaphy technique using endoscope is expected to give better result than conventional method.