Flexor tendon injuries. Part 4. Staged flexor tendon reconstruction and restoration of the flexor pulley.

Staged reconstruction of the flexor tendon is discussed and several surgical techniques involving implantation of a silicone or silicone-Dacron-reinforced gliding prosthesis into a scarred flexor tendon bed are described. Flexor pulley restoration and the importance of maintaining strong pulley support are discussed and surgical techniques including those for flexor tendon grafting and reconstruction are described. Though the results of these procedures leave much to be desired, the proper technique utilized under the right circumstances can restore satisfactory function following interruption or destruction of flexor tendons.