Abstract
1. A series of 149 consecutive cases of flexor tendon grafting in the fingers and thumb is reviewed and the results are analysed. A description of the technique which has evolved from this experience is given.
2. Replacement of a divided flexor digitorum profundus in the presence of an intact sublimis tendon restored a useful range of movement in 80 per cent of cases.
3. Replacement of both flexor digitorum profundus and sublimis gave good results in 70 to 80 per cent of cases.
4. Replacement of a divided flexor pollicis longus tendon gave good results in 85 per cent of cases.
5. The particular tendon used for the graft did not materially influence the result, but there are special indications for the use of the different tendons.
6. The choice of splintage or of early movement after operation does not appear to have a significant bearing upon the result.
7. The most important factor in determining the result is probably a precise and gentle surgical technique and complete haemostasis. Minor differences in method are of little importance. The failures in this series were due more to faulty performance of the operation than to any other single factor.
