Endoscopic Retrieval of Severed Flexor Tendons: A Study of Technique Using Cadaveric Hands

Abstract

Retrieval of retracted zone 1, 2, and 3 flexor tendons without a proximal incision can occasionally lead to excessive tendon trauma or injury to neurovascular structures. To determine if endoscopic flexor tendon retrieval is a reliable, reproducible technique, 34 zone 2 flexor tendon lacerations were created in four cadaveric hands (2 male; 2 female). The tendons were retracted proximally an average of 4.3 ± 1.9 cm (range, 2–10 cm) through a separate transverse wrist incision. A 2.5-mm flexible endoscope was introduced into the distal tendon sheath, and all transected tendons (N = 34) were clearly visualized. Thirty-two tendons (94%) were retrieved endoscopically by using either a loop snare or grasping forceps. Two tendons (6%) in a small female hand could not be retrieved endoscopically. This minimally invasive technique may be an alternative to the blind grasping maneuvers, proximal incision extensions, and counter-incisions in the palm.