Step Cut Lengthening

Abstract

Reconstruction of a tendon defect is a challenging task in hand surgery. Delayed repair of a ruptured flexor pollicis longus (FPL) tendon is often associated with tendon defect. Primary repair of the tendon is often not possible, particularly after debridement of the unhealthy segment of the tendon. As such, various surgical treatments have been described in the literature, including single-stage tendon grafting, 2-stage tendon grafting, flexor digitorum superficialis tendon transfer from ring finger, and interphalangeal joint arthrodesis. We describe step cut lengthening of FPL tendon for the reconstruction of FPL rupture. This is a single-stage reconstruction without the need for tendon grafting or tendon transfer. To our knowledge, no such technique has been previously described.

Subcutaneous Transposition of the Flexor Pollicis Longus: Does It Provide Increased Length for Tendon Repair? A Cadaveric Study

“…In an effort to prevent undue tension at the repair site, techniques like interpositional tendon graft have been developed for gaps of 5 cm 10 as well as step-cut lengthening for gaps of 2 cm. 11 It has traditionally been left to surgeon discretion regarding the optimal surgical technique for a given length gap without a clear consensus. This technique, while limited, is potentially another tool in a surgeon’s armamentarium.…”