Pull out suture using the plunger flange of the syringe, a better alternative to the button

: Tendon avulsions within zone 1 of the hand presents challenges for repair. The traditional technique involves using a button to secure the tendon sutured to the bone. This study explores an alternative method utilizing the plunger flange of a syringe.: The study involved patients with zone 1a and 1b injuries. The plunger flange technique was employed by drilling two holes in the plunger, passing a polypropylene suture through them, and securing it with a sterile knot. The technique was compared with the traditional button approach.: The plunger flange technique demonstrated feasibility and effectiveness in tendon avulsion repair. Plunger flanges, which eliminated the need for separate sterilization, were more readily available. Patients could initiate therapy sooner post-surgery. Complications, although limited, resembled those of the traditional button method. The plunger flange technique presents a viable alternative to the button in repairing tendon avulsions. This method is easily accessible, doesn't require separate sterilization, and allows for early therapy initiation. The study suggests that the plunger flange technique could be recommended as a replacement for the button.