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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