Two-stage flexor-tendon reconstruction. Ten-year experience.

One hundred and fifty fingers in 136 patients were treated by a two-stage flexor-tendon reconstruction and followed for an average of 2.4 years. A salvage procedure such as this was needed for most of these fingers since 81 per cent of the injuries were in Zone 2 and 45 per cent were Grade 5 in severity. Before reconstruction, the mean total active motion (all joints combined) for each finger was 102 degrees and the mean grip strength was 20 per cent of normal. At final follow-up, the mean total active motion of these fingers was 176 degrees and the mean grip strength was 79 per cent of normal. Three months after tendon-grafting, the results had reached a plateau, and no significant change occurred thereafter. Complications were a flexion contracture of varying degree in 41 per cent of the fingers, especially when a contracture was present preoperatively (40 per cent); rupture of the tendon graft in 14 per cent; and infection in 4 per cent. This review reaffirmed the usefulness of two-stage flexor-tendon reconstruction as a salvage procedure to restore function of flexor tendons.