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The Direct Midlateral Approach with Lateral Enlargement of the Pulley System for Repair of Flexor Tendons in Fingers

From the Traumatologic and Orthopaedic Hospital, Torino and the First Orthopaedic Clinic, University of Milano, Milano, Italy

Correspondence: Dr A. Messina, via Monte Rosa 20, 10098 Rivoli (Torino), Italy.

The direct midlateral approach and the lateral enlarging procedure of the pulley system have been utilized in our service since 1972. The incision runs directly behind the neurovascular pedicle, which is left in the palmar skin flap of the anterior compartment of the finger, in order to ensure its blood supply and sensibility. The transverse digital lamina of Landsmeer’s skin anchoring system and Cleland’s ligament are preserved and are used to perform a lateral enlargement of the pulleys after tendon repair. The technique allows wide surgical exposure of the digital fibro-osseous tunnel, enlargement and reconstruction of the pulley system and tendon sheath, flexor tendon repair (using the technique of choice) and reduces postoperative impingement in zone 2.

Journal of Hand Surgery (British and European Volume), Vol. 21, No. 4, 463-468 (1996)
DOI: 10.1016/S0266-7681(96)80047-7


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