Flashcards on Flexor Tendon Injuries of the Hand

Flexor Tendon Injuries of the Hand: A Student Guide

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When preserving the flexor sheath during reconstruction, what principle regarding resection is emphasized?

Minimize resection—preserve as much uninvolved flexor sheath as possible rather than removing it except for necessary areas (contrasting older teachin

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Flexor tendon reconstruction overview & techniques

97 cards

Card 1

Question: When preserving the flexor sheath during reconstruction, what principle regarding resection is emphasized?

Answer: Minimize resection—preserve as much uninvolved flexor sheath as possible rather than removing it except for necessary areas (contrasting older teachin

Card 2

Question: Why must handling, pinching, or probing of tissues be minimized during flexor tendon reconstruction?

Answer: To reduce the risk of increasing the number and density of adhesions.

Card 3

Question: How much of the FDP distal stump is typically preserved during preparation for a graft?

Answer: Approximately 1 cm of the FDP stump is preserved distally.

Card 4

Question: If the injured FDP tendon is of poor quality, what tendon options can be used as the motor for the graft?

Answer: Use the transected FDS tendon of the injured digit, or alternatively the FDP tendon of an uninjured digit if both injured tendons are unsuitable.

Card 5

Question: What is done when both digital flexor tendons of an injured finger are nonfunctional?

Answer: The proximal FDS stump is pulled distally and transected to let it retract proximally; the distal FDS tendon is sharply excised leaving 1–2 cm of its

Card 6

Question: Why is 1–2 cm of the distal FDS insertion left intact when excising the distal FDS tendon?

Answer: Because it provides a more favorable posterior bed for the graft than a freshly operated, granulating area and may help prevent PIP hyperextension by

Card 7

Question: What should be done to the wound before harvesting the graft from the lower extremity?

Answer: Cover the wound with a moist dressing and, if harvesting from the lower extremity, release the tourniquet prior to harvest.

Card 8

Question: Name some devices used as passers to thread a tendon graft under the pulleys.

Answer: Flexible rubber catheter (pediatric feeding tube or red rubber catheter), flexible silicone tendon implant, or a Swanson disposable suture passer.

Card 9

Question: What precaution is emphasized when passing the graft beneath the pulleys?

Answer: Minimize trauma to the intact sheath while threading the graft.

Card 10

Question: What technique is preferred by the authors for distal juncture of the graft to bone or stump?

Answer: An “around-the-bone” technique to fasten sutures rather than passing sutures through bone and nail matrix; they find it less cumbersome and have not e