Abstract
To minimize adhesions following tendon repair, early post-operative movement is recommended. This has proved difficult with tendon grafting because of weakness of the repair sites, particularly distally, and because of slow revascularization.
A potential solution is the use of a composite tendon-bone graft in which a bone block is attached to the end of the tendon. The tendon is threaded through a hole in the distal phalanx from the dorsal to the palmar side and impacted like a cork to create an immediate strong fixation. The tendon itself is then tunnelled through the pulley system and the proximal repair is carried out with a multiple weave technique which can withstand immediate active movement.
The ideal tendon-bone complex is the plantaris attached to a segment of calcaneus.
A preliminary report with two case studies is presented.
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