We report our experience of using double or multiple looped sutures for primary tenorrhaphy combined with early active mobilization. In 46 patients involving 51 fingers with flexor tendon lacerations, double threads of the looped nylon suture were placed to repair injured FDP or FDS tendons, or three threads of looped nylon suture were made to repair the FDP tendons. Using White's (1956) criteria, the results were good or excellent in 76.5% of fingers. The double and multiple looped sutures are of sufficient strength to sustain early motion, and cause little disturbance in the circulation. Satisfactory function following primary tendon repair can be expected with these new techniques.

Autogenous vein graft was used to fill 18 digital nerve defects between 0.5 to 5.8 cm in length during flexor tendon surgery in zone 2. The vein was taken from the forearm and reversed to bridge the digital nerve. For nerves with defects over 2.0 cm, normal nerve slices were inserted inside vein conduits. Recovery of sensibility was evaluated by von Frey test, pin-prick detection, localization of stimulus, moving two-point discrimination and sweating on the finger pulp. Follow-up revealed excellent recovery in two digital nerves, good in nine, fair in five and poor in two. The results suggest that vein graft provides a simple and practical method to reconstruct a digital nerve defect during tendon repair in zone 2.

Ten cases with gaps in nerve trunks in the forearm were treated by interfascicular grafts of autogenous veins. These included three cases of median nerve injuries, five cases of ulnar nerve injuries and two cases of radial sensory nerve injuries. The nerve gaps ranged from 1.5 to 4.5 cm with an average of 3 cm. Completely divided nerve trunks were repaired by two or three vein conduits. For incomplete nerve injuries or replacement of a single fasciculus, a single vein conduit was used. For nerve defects over 3 cm, normal nerve tissues were sectioned from the proximal nerve fasciculus and inserted into the vein conduits. These cases were followed for 2 years and 2 months to 3 years. The results were M3 in two, M4 in six and S2 + in two, S3 + in seven and S4 in one nerves. This study suggests that interfascucular grafts of vein conduits can be applied in patients with nerve gaps shorter than 4.5 cm and with favourable wound conditions with fairly good clinical results. Interfascicular vein graft provides an alternative treatment option for gaps in distal peripheral nerve trunks.