The fate of tendon healing after restoration of the integrity of the tendon sheath with autogenous vein grafts

This experimental study in the chicken model compares the results of sheath closure during primary tendon surgery. Sheath closure after tendon grafting was accomplished by trapdoor of the original sheath, vein patch, and vein conduit. After casting in flexionfor 14 days, the operated foot and digits were taken through a full passive range of motion every 3 days. At the 28th postoperative day, all immobilization was removed and free active range of motion and daily perching began. Active flexion was measured after death by continuous traction on the proximal profundus tendon: simulated active flexion. The unoperated contralateral foot served as the control. All operated middle toes achieved significantly greater functional return when the sheath was restored either with trap-door closure, vein conduit, or vein patch compared with simple excision of the sheath. The results indicate the efficacy of sheath closure as well as the possibility of utilizing vein patches or conduits during primary tendon repair.