By Konstantinos T. Ditsios, MD, PhD

All hand surgeons experience difficulty retrieving the proximal part of a disrupted flexor tendon through uninjured pulleys, especially in zone II. Many methods have been described but it all ends in personal preference and tools adequacy. The tool I choose to use is a vascular tourniquet kit commonly used by cardiac surgeons with the following steps. Firstly, I pass the wire through the sheath. Then I place a suture between the loop of the wire and the tendon. Finally, I retrieve the retracted tendon in the distal wound and cut free the suture. This method gives me the benefit of leaving all pulleys intact and while making the least amount of damage to the tendon end, which provides easier repair and less scarring in optimum time.