One hundred tendon grafts for isolated flexor digitorum profundus injuries

One hundred cases of isolated flexor profundus tendon laceration or rupture were repaired by tendon graft over a 30-year period. Thirteen patients were over 40 years of age with the age range in the study from 1 1/2 to 60 years. Unless the flexor profundus tendon remained in the decussation of the superficialis, all grafts were placed around the superficialis tendon decussation. Measurements of passive tendon excursion were considered critical in the selection of a motor for the tendon graft. All but two profundus graft motors could be passively extended to 30 mm. Average active distal interphalangeal (IP) joint flexion was 48 degrees following surgery. In thirteen patients the results were considered unsuccessful, with loss of greater than 20 degrees from preoperative proximal IP joint flexion or distal IP joint flexion less than 20 degrees. We suggest that, in properly motivated patients, tendon graft replacement of isolated profundus tendon injuries can give satisfactory results even in the older age group.