To the Editor:
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.
1Tendon 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.
- Wu Y.F.
- Tang J.B.
Effects of tension across the tendon repair site on tendon gap and ultimate strength.
J Hand Surg Am. 2012; 37: 906-912
- Seiler III, J.G.
Flexor tendon injury: acute injury.
in: Wolfe S.W. Green's Operative Hand Surgery. 6th ed. Elsevier, Philadelphia, PA2011: 199-200
- Dy C.J.
- Hernandez-Soria A.
- Ma Y.
- Roberts T.R.
- Daluiski A.
Complications after flexor tendon repair: a systematic review and meta-analysis.
J Hand Surg Am. 2012; 37: 543-551
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.
- Effects of tension across the tendon repair site on tendon gap and ultimate strength.J Hand Surg Am. 2012; 37: 906-912
- Flexor tendon injury: acute injury.in: Wolfe S.W. Green's Operative Hand Surgery. 6th ed. Elsevier, Philadelphia, PA2011: 199-200
- Complications after flexor tendon repair: a systematic review and meta-analysis.J Hand Surg Am. 2012; 37: 543-551
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.