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- See:
      - Excursion, of Tendons
      - Staged Flexor Tendon Repair
      - Tendon Repair Technique
      - Pulley Reconstruction
      - Tendon Sheath Anatomy

- Anatomy:
    - on volar aspect of finger, FDP passes thru FDS to insert on distal phalanx;
    - both long flexor tendons are tightly enclosed in common tendon sheath which corresponds to zone II;
    - this anatomical proximity explains the development of adhesions between FDS & FDP tendons & digital fibrous sheaths following injury;

- Contraindications to Tendon Grafting:
    - neglected tendon lacerations more than 6 weeks old;
    - severely contaminated wound;
    - loss of tendon substance of greater than 1.5 cm
    - loss of the A2 pully, the A4 pulley, or both;
    - if wound is contaminated delayed repair (10 days) is possible w/ good results;

- Tecnique:
    - graft bed is prepared prior to harvest of the donor tendon;
    - remaining portion of the profundus tendon is resected to the mid palm level;
    - 1 cm of the distal profundus stump is saved to further augment distal graft anchorage;
    - donor tendon:
           - donor tendon should not be larger than FDP since this will overcrowd the tendon sheath;
           - usual donor tendons include: palmaris longus, extensor indicis, and central toe extensors;
           - never use a donor tendon w/ a longitudinal split (such as from the FCR) since this will cause adhesions;
    - tendon is passed through the tendon sheath either through the FDS chiasm or around it;
    - anchor distal end of tendon graft first (see pull through technique);
    - proximal tendon graft anchorage:
           - optimizing graft tension
           - pulvertaft weave is utilized;
           - do not incorporate lumbricals into the repair;

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- Post Operative Care

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Single-stage flexor tendoplasty in the treatment of flexor tendon injuries

Bridge flexor tendon grafts.

Angiogenesis in healing autogenous flexor-tendon grafts.

Autogenous flexor-tendon grafts. A biomechanical and morphological study in dogs.

Work of flexion after flexor tendon repair according to the placement of sutures.