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How to treat tendon injury of the palm?

Q: There is rupture of palmar tendons of both hands due to accidental injury on 16-8-2002 during erection of galvanised iron (tin) shed. Left hand muscles and palmar tendons sutured and slab given by surgeon. Right hand end-to-end suturing could not done due to palmar skin damage. Some sutures were septic, and as suggested by another surgeon, sutures were removed and wound was made to bleed for quick healing. There is a horizontal triangular skin loss(about 4 cms) and also, 3 fingers are bending outwards but not inwards. So please guide regarding further clinical and surgical treatment?

A:The right hand wound should be treated by debridement and flap covered. Tendon repair may be done now or may need to be postphoned to second stage. This will depend upon the condition of the wound.


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