Stage one of Two Stage Reconstruction Of FDP

FLEXOR RECONSTRUCTION

INDICATION

Patient is a case of electrical burns who sustained injury to his Ring finger.There was no Bony injury at that time only flexor tendons and pulley was damaged.So patient was given groin flap for stable skin cover.

INCISION

After flap settling well and joints were all mobilized nicely.Now planned for two stage reconstruction of FDP with silicone rod and pulley reconstruction at first stage then tendon graft in the second stage.

Here incision is made over the neutral line  extending upto the zone 3 level. Separate incision made over the zone 5 level for identifying Fdp and Fds to Ring finger.

GRAFT

Sural nerve graft harvested and used to bridge the digital nerve .

SILICONE ROD

Distally cut end of FDP identified amd secured as also the cut digital nerve. Proximal zone 3 level tendons are identified and the looping done for later identification. 

Pulleys reconstructed at A2 A4 level using Fds grafts.

SilIcone rod anchored over the distal cut end of FDP and passed through the pulley system reconstructed.

Silicone rod tunneled and kept at the zone 5 level .

CLOSURE

Skin closed and drains kept and Dorsal PoP given .

Post operatively Mobilsation within PoP after 2 days .