Staged flexor tendon reconstruction in the fingers and hand.

A two-stage tendon-grafting technique was used to reconstruct 130 fingers in 101 patients between 1973 and 1984. Eighty-nine patients with 117 fingers that had undergone operation were evaluated 6 months or longer after stage II surgery. Sixty-five percent of the patients were in the Boyes salvage group before operation. Overall, 54% had good or excellent results by the total active motion (TAM) as a percentage of total passive motion (TPM) method, although only 19% had final TAM of greater than 180 degrees. Complications included infection in 15%, rupture in 4%, amputation in 4%, and reflex sympathetic dystrophy in 1% of the patients. Sixteen percent of the patients required tenolysis after stage II surgery. Factors associated with a poor result included zone I or II injury and patients who were less than 10 years of age. Factors associated with a better result included zone IV or V injury and all postoperative therapy under the direct supervision of the treating surgeon.