Clinical application of biological membrane for reconstruction of A2 pulleys in tenolysis

Objective To explore the surgical technique and clinical efficacy of biological membrane for reconstruction of A2 pulleys in flexor tenolysis. Methods From July 2015 to December 2016, 10 cases of digital flexor tendon adhesion were treated. When the pulley system could not be repaired in situ after flexor tenolysis, pulley base (firmly combined with the tissue around the tendon) and body were made from biological membrane to be used for reconstruction of A2 pulleys. After the operation, functional exercises were performed under the protection of braces. Results All the wounds achieved primary healing after the operation. No foreign body reaction, abnormal exudation, redness, swelling, heat, pain, non-union or delayed union occurred. According to the evaluation criteria of Strickland and Glogovac, the results were graded as excellent in 4 fingers and good in 6 fingers within 48 hours after operation. The patients were follow-up form 6 to 18 months with the average of 11 months. According to the evaluation criteria of Strickland and Glogovac, the results were graded as excellent in 4 fingers and good in 6 fingers. No tendon rupture occurred again. The total flexion activity of fingers was improved, ranging from 135° to 260° with an average of 200°. No bowstring deformity occurred in the affected fingers after operation. Conclusion Biological membrane could be used for reconstruction of A2 pulley, which provides a new material for pulley reconstruction in tenolysis. It is a simple and effective method. Key words: Tendon injuries; Treatment outcome; Tenolysis; Pulley reconstruction; Biological membrane