Tendon Repair

dr. Fajar Ivan Effendi, Sp.OT

Tendon Repair
• Can be done a few days after the trauma
• Urgent repair : NVD disturbance or open rupture
• Delay : tendon graft or spacer
Suture material
• Monofilament stainless steel -> highest tensile strength, makes large
knot : distal forearm
• Absorbable suture (catgut, polyglycolic acid group): weak to early
after surgery
• 4-0 suture is estimated to be 66% stronger than a 5-0 suture
Tendon to Bone Repair
2 technique:
• Traditional pull-out suture methods
• In the traditional technique the end of the thread is placed outside on the
finger nail and will be removed after 6 weeks
• Internal suture methods
• No need removal
Tendon Repair
Flexor Tendon Repair
Techniques for end to end flexor tendon repair
Debridement
• At operation all infected soft tissue and dead or
devitalized bone, as well as any infected implant, must
be excised. The wound is inspected after 3 or 4 days
and, if there are renewed signs of tissue death, the
debridement may have to be repeated – several times
if necessary. Antibiotic cover is continued
• Possible if the original wound extended
• Ideally joint with plastic surgeon
Postoperative Care
▪ Apply dorsal splint with wrist and MP joints flexed and PIP and DIP joints at 0 to 10
degrees
▪ Use a graded rehabilitation protocol under supervision of a qualified therapist.

Return to Activities
▪ The patient may return to full activity at 4 to 6 months after surgery.
• Wilhelmi BJ. 2014. Flexor Tendon Repair dalam Chung KC,
Gosain A, Gurtner GC, Mehrara BJ, Rubin JP, Spear SL (Eds).
Grabb & Smith’s Plastic Surgery 7th Edition. Lippincott
Williams & Wilkins. Philadelphia.
• Grear BJ.2021. Disorder of tendon and fascia and
adolescent and adult pes planus in Azarth FM and beaty JH.
Campbell’s Operative Orthopaedics 14
edition.Elsevier.Philadelphia
• Cannon DL.2021 Flexor and Extensor Tendon injuries in Azar
FM and beaty JH. Campbell’s Operative Orthopaedics 14th
edition.Elsevier.Philadelphia