Dear Sir,We present an alternative surgical technique for the treatment of traumatic avulsion of the flexor digitorum profundus (FDP) from its insertion. Surgery is performed through a palmer extensile midlateral incision (Figure 1A). The tendon is drawn out through a transversal tendon-sheath incision between the A2 and A3 pulleys. A 28-gauge monofil-ament stainless steel wire is introduced transversely in the tendon, 5 mm proximal to the end. Two modified Becker sutures (3-0 braided polyester suture, Ethibond) are placed in the distal 1.5 cm of the tendon (Figure 1B,C] and tied to hold the wire (Figure 1D). The wire and tendon are guided through the pulleys to the insertion site of the tendon on the distal phalanx (Figure 1 E). At each side of the insertion site a bony tunnel is established dorsodistally using a 0.8 mm K-wire. The K-wire exits 5 mm proximal to the eponychium. The stainless steel wire is then passed dorsally through the tunnels through syringe needles. A 0.8-1 mm diameter K-wire is inserted in an anterograde manner from the fingertip to base of the distal phalanx. A loop is made in the K-wire at about 2.5 cm distal to the fingertip.
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