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Primary tendon repairs are often difficult in patients with delayed presentation. Tendons are contracted and shortened with extensive scarring occurring along the path of the tendon. Pulleys and the wound bed can be filled with granulation tissue which obstructs the passage of the tendon. Many of such patients would then be treated with a two stage tendon reconstruction, which involves the insertion of a silicone rod for pseudosheath formation[1] before tendon grafting at a second stage. This however, would set the patient back for roughly six months, especially involving multiple visits to physiotherapy and being off work. We would like to describe several tips and tricks in our armamentarium and illustrate these using a case we recently encountered [Figure 1].

Tips and tricks for getting more out of your delayed primary repair of ruptured flexor pollicis longus tendon