In Israel, three main methods of tendon reconstruction are used. These are tendon suturing, one-stage tendonoplasty, and two-stage tendon damage repair. The choice of treatment method is determined by many factors. Among them are the time since the injury occurred, the extent of tendon deformation, the condition of the skin, and the presence of inflammation in other soft tissues around the tendon.
Treatment
Tendon injuries with avulsion from the bone are most often treated by connecting the ends of the tendon with the application of a splint (provided that the degree of damage does not exceed 50%) – this is tendon suturing. Such treatment is possible if the injury is a clean cut, without signs of infectious inflammation, and no more than 12 days have passed since it occurred. If the tendon is completely severed, reconstruction is performed by suturing. Currently, transarticular closed fixation of tendons is often used, carried out using a thin pin passed through the interphalangeal joint of the finger. A cast is applied to the finger for up to 6 weeks. The main goal of tendon reconstruction is to restore tissues and preserve all motor functions of the fingers.
Tendonoplasty
Tendonoplasty involves restoring the functions of the tendon by replacing the pathologically deformed part of the tendon with a graft of appropriate size. To ensure proper sliding of the graft and tendon, a low degree of deformation is a necessary condition. Successful one-stage tendonoplasty is possible with moderate damage and the absence of complicating factors for the surgery – large area of damage, poor scar healing, skin deficiency, joint pathologies. In this case, two-stage treatment is recommended. The first stage of such reconstruction aims to eliminate negative factors.
To restore the entire chain of the motor chain, complete recovery of muscle functionality is necessary. For this, the patient is prescribed active physical exercise, muscle electrical stimulation, and physiotherapy.
Normal transmission of movement is possible not only with the assistance of all connective and soft tissues but also with the integrity of the support apparatus (bones of the skeleton and joints).
The positive result of tendonoplasty depends not only on the initial data of the patient but also on the cumulative positive interaction of all the listed elements. A crucial point is the successful fusion of the graft, tendon, and soft tissues. This requires good recovery capacity of the body and a serious rehabilitation program.