What are the options available to handle distal flexor lacerations?
For a laceration that is immediately proximal to the A4 pulley, several surgeons have utilized the following technique: (Also see Distal Repair Technique) • To manage the distal stump, an option is to bring the tendon out from under the A4 pulley in order to obtain exposure. The installation procedure of placing a Teno Fix® anchor can now be completed including the placement of the Teno Fix® stainless steel suture assembly. • After closing the tenotomy, encapsulating the Teno Fix® anchor, the Teno Fix® suture may now be used to navigate the distal stump back under the A4 pulley. Options to return the distal stump under the pulley are discussed in question 15. • The repair is then completed after placing the proximal anchor, delivering the stainless steel suture through the proximal anchor and crimping on the proximal side.
