[Repair of the flexor digitorum profundus and the flexor pollicis longus by the "rope down" technique. Results in a series of 77 cases].

UNLABELLED: Seventy-seven flexor tendon lesions in zone I have been reinserted by the "rope down" technique using the Jennings barb-wire. They included 20 cases of repair of FPL. The patients were reviewed with an average follow-up of 4 years (minimum 3 months, maximum 10 years). By means of this technique, immediate active mobilisation was possible in 70 of the 77 cases. Mobility of the MCPJ and the PIPJ was maintained in all but one case. At DIPJ level active flexion was recovered at an average of 42.8 degrees with an average extension deficit of 5.5 degrees. This corresponds to a 1.3% (D1) and 2% (D2-D5) handicap as assessed by the International Federation of Hand Surgery. Complications were recorded in 12 of the 77 cases. Two cases required a secondary tenolysis. The factors which influence on the result were analysed. This analysis demonstrates the frequency with which the association of other lesions worsens an outcome which, traditionally, is otherwise good. The average time off work was 6.9 weeks (minimum 0, maximum 6 months).

IN CONCLUSION: this simple, rapid technique achieves secure reinsertion allowing immediate active mobilisation. The use of barb-wire demands meticulous surgical technique and close post-operative surveillance. These requirements indicate why this method does not readily lend itself to the management of these lesions in infants.