Tendon Repair: Zone I and II Flexor Tendons and Extensor Tendons

Tendon injuries in the hand are common, yet represent some of the most challenging problems in the hand to both patient and surgeon. The goal is for a repair or reconstruction to be strong enough to allow for early active range of motion, yet to retain its anatomic morphology to allow for smooth gliding. This review will discuss optimal repair characteristics and will offer a suggestion of techniques that are effective and applicable to the daily practicing hand surgeon. The focus will be on zones I and II flexor tendon repairs and reconstruction and extensor tendon repair. The anchor button technique for zone I injuries and reconstruction, cross-locked cruciate–interlocking horizontal mattress repair method for zone II injuries, and the running-interlocking horizontal mattress method for extensor tendon repair provide excellent biomechanical characteristics that allow for early active range of motion. Rationale for these techniques with specific descriptions will be presented.