Drawings of flexor tendon sutures illustrate tidy, precise mechanical connections between tendon ends, but reality is not so perfect. In this cadaver finger, the flexor tendons are repaired with colored suture material (used for clearer illustration). The green suture is the core suture and the blue is the epitenon circumferential suture.
Even a sharply divided tendon repaired by a skilled surgeon under the best of circumstances produces a comparatively bulky contour at the repair site due to the pliable nature of the tendon. It is easy to imagine why re-establishing tendon glide within the tightly fitting tendon sheath of the finger can be challenging!
An article entitled Suture Techniques for Tendon Repair; A Comparative Review by Rawson, Cartmell & Wong provides a useful overview of flexor tendon sutures.
© HandLab; 2016 all rights reserved
Disclaimer: HandLab’s What Do You See? is intended to be an informal sharing of practical clinical ideas; not formal evidence-based conclusions of fact.