الفهرس 
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Abstract
Acute flexor tendon injuries should be repaired primarily with an atraumatic technique, which in combination with a postoperative controlled motion rehabilitation protocol can usually prevent adhesion formation and provide good results. However, old flexor tendon injuries, especially in zone II, are usually associated with complications such as tendon retraction in both proximal and distal ends, adhesion formation, and secondary abnormalities of digits. Therefore, tendon grafting is usually needed to restore the flexion function of digits.
Although disagreement exists as to which donor tendons should be chosen for free flexor tendon grafting, the palmaris longus and Plantaris tendon, when available, likely has the most advocates. Although good results have been obtained by grafting, many patients need tenolysis to improve tendon moment. Tenolysis is a technically demanding surgical procedure. When performed properly, tenolysis is a worthwhile effort at restoring digital function, but the clinical efficiency of this procedure is questionable. Tendon rupture is a severe complication after tenolysis.
Adhesion formation is the most frequent complication after primary tendon repair and tenolysis. Methods for preventing adhesions include early postoperative motion protocols, preservation of sheath and pulley components, mechanical barrier to adhesion formation.
For those patients who are not satisfied with result of primary repair and tenolysis and not suitable for single-stage tendon graft, staged flexor tendon reconstruction using a silicone rod provides a good alternative. In the 1963s, Bassett and Carroll began using flexible silicone rubber rods to build pseudosheath in badly scarred fingers, and the method was later refined to a 2-stage reconstruction of the digital flexor tendons by Hunter and Salisbury. It is a long process in which many factors must be carefully considered by physician and patient, and the status of the digital tissues, including the skin, nerves, vessels, and joints, weigh heavily in determining the appropriateness of proceeding with such a complex and multi-staged restorative effort. This procedure was used for patients who had their flexor digitorum profundus, flexor digitorum superficialis, and tendon sheath all severely injured, especially in zone II, and it decreased adhesion formation effectively. Hunter’s technique is worthwhile for delayed flexor tendon injury in zone II to prevent adhesion formation.