Flexor Tenolysis Using a Free Suture

Optimization of Flexor Tenolysis Using a Suture

“…[9][10][11] Its great advantage is the use of an instrument that can cut and is flexible at the same time, being able to adapt to narrow spaces between the tendons and the digital canal. Such characteristics facilitate the section of the adhesions without opening or traumatizing the pulleys.…”

“…In his article, Bain (2003) described the use of the needle of the Prolene 2-0 suture to pass it under the pulleys. According to his description, it is possible to understand that tenolysis involves the spaces between the tendon and the pulleys in the anterior and lateral portions as well as the posterior portion between the tendon and the phalanx.…”

“…The technique employed by the senior author of this study is based on the studies by Bain (2003), Azad (2004), and Le Viet (2004), who suggested the use of a monofilament suture to release the peritendon adhesions. [9][10][11] The main advantage of this technique is the flexibility of the suture, which allows its insertion and traction inside the canal, cutting even the fibers that are difficult to reach without damaging the relevant anatomy of the pulleys.…”

“…[9][10][11] The main advantage of this technique is the flexibility of the suture, which allows its insertion and traction inside the canal, cutting even the fibers that are difficult to reach without damaging the relevant anatomy of the pulleys. However, the use of cutting the suture does not resolve the problem of the restrained exposure of the tendons in zone 2 at the chiasma site.…”

Effectiveness of flexor tenolysis in zone II: A retrospective series of 40 patients at 3 months postoperatively

“…The two-flexor tendons were then separated. If necessary, particularly to loosen the tendons from the pulleys or to separate the deep flexor tendon from the superficial tendon, the ''butter wire cutter'' technique was used [3]: a Vicryl 1 2-0 suture was passed through a plane parallel to the tendons, gently pulling and pushing it to-and-fro to cut through the adhesions in the narrow zone II space. The A2 or A4 pulleys were either left intact or reconstructed to allow for early active mobilization.…”