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Rupture of Flexor Tendon Repair


- Discussion:
     - tendon ruptures can occur as an early or late complication (6 to 7 weeks)
            - most occur around post op day 10;
     - after primary repair, most likely site for failur is at repair site;
     - if rupture is recent, reanstomose tendon;
     - if rupture is older than 1-2 weeks, reanastomosis is not likely to be possible w/o significant tendon shortening;
             - if superficialis is normal, tendodesis or arthrodesis is performed on the distal IP joint;
                   - tenodesis is better choice than arthrodesis since there is retained passive flexibility of distal phalanx which is important in grasping small objects;
     - after 6 weeks, re-anastomosis will not usually be possible and surgeon should consider stage flexor tendon repair;
     - if FDS has been lost, complex reconstructive procedures are needed;
            - may include:
                  - insertion of prosthesis
                  - joint release and pulley reconstruction
                  - tendon grafting