Over the radial side of the left thumb there is a healing 12 mm transverse skin laceration. The patient is unable to flex the IP joint. thumb extension is normal and so is opposition and abduction. Sensation and circulation to the distal thumb are normal.
Fig. 1. Healing wound in left thumb from knife laceration 2 weeks earlier.
Fig.2. Shows no IP flexion in left thumb.
The patient was taken to the OR and under axillary block anesthesia the tendon was retrieved at the level of the carpal tunnel. It was threaded through the tendon sheath to the level of the laceration and repaired with a modified Kessler repair with epitendinous suture.
Fig.3. Flexor pollicis longus tendon retrieved in the carpal tunnel.
Fig.4. Shows the repaired tendon.
At three months she had regained full IP flexion as well as well opposition and abduction.
Fig.5. Shows IP flexion of left thumb.
Fig. 6. Shows opposition of left thumb.