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During primary tendon repairs and tendon transfer operations, tendon ends have to be smooth and tidy to achieve optimum tendon healing. Although minimal handling is imperative, holding the tendon and trimming the ends are difficult because the epitenon and synovial fluid makes the tendon slippery. Multiple efforts to tidy the ends can cause further shortening and cause increased tension in the repair zone, which can lead to tendon repair rupture.
Tendon ends are also exposed to blunt trauma from being held with forceps in the course of these prolonged efforts, and the epidentinous injury can be associated with peritendinous adhesion formation.
To strip and smooth the tendon ends, we use an ethylene oxide–sterilized wooden tongue depressor. We lay the tendon ends on the tongue depressor to stabilize them, and can then easily cut the ends or strip along the tendon with a scalpel (Fig. 1). We prefer a dry wooden tongue depressor, and the scalpel direction proceeds with no deviation. We have not observed complications as the result of using a tongue depressor. We confidently recommend this technique to our collegues as an effective, safe, cheap, and easily available method of smoothing and stripping the tendon ends.
Figure 1Stripping and smoothing the tendon ends over a sterile wooden tongue deppressor during a flexor digitorum superficialis 4-tail procedure for correcting a claw hand deformity.
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