[Reoperation after surgery of flexor tendons].

Abstract

After stabilizing operations such as tenodesis or arthrodesis used for lesions of flexor tendons in the hand, secondary operations to achieve more suitable angulation are mainly needed when there is elongation of the tenodesis. Complications are more frequent after mobilizing operations such as reinsertion, advancement, Z-lengthening, primary suture, tendon graft or tendon transfer. Tenolysis, the operation most frequently used, since contractures may occur after all the prementioned procedures, is treated in a separate paper. Tendon rupture, for instance after reinsertion or advancement operations may require repetition of the primary procedure. More often another procedure will be indicated, for instance a graft after rupture of a primary suture. Pulley reconstruction is necessary when correction of bow-stringing is the aim. Synovitis after the first stage of HUNTER's tenoplasty, a consequence of mechanical or chemical irritation from the silastic rod, is best treated by a short period of immobilisation. Tardy, secondary contractures after tendon graft are a real problem. If conservative treatment using splints is ineffective, either the hook-deformity has to be accepted or the finger amputated.