Tendon Passage using PONTiS Catheter and Funnel

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  1. Once the cross lock has been placed in the proximal tendon it is now ready to be passed through the pulley system using the PONTiS catheter and funnel
  2. The needles are cut off close to their attachment to the suture
  3. The narrow blunt end of the catheter is passed into the pulley system from the finger to the palm and is retrieved in the palm incision. The catheter enlarges from one end to the other so as it is passed it opens and dilates the pulley canal. It can be passed back and forth gently to ensure easy passage of the tendon. Withdraw the catheter slightly so it can be easily removed later
  4. Cut the catheter at both ends leaving it approximately 1cm from the skin surface on both sides
  5. Pass both sutures through the funnel introducer and then place the funnel over the tendon end. Then thread the sutures through the lumen of the catheter and out of the far end
  6. At this point make sure that the tendon orientation for passage is correct
  7. It is extremely important to clamp the sutures on the far side of the catheter. This will hold the tip on the funnel inside the lumen of the catheter and hold the tendon end firmly within the funnel. This will avoid any catching as the tendon enters and traverses the pulley system. Make sure the position is correct before passing the tendon
  8. Pull on the catheter and the clamp and easily deliver the tendon
  9. Remove the catheter and funnel and the tendon with the cross-lock attachment already in place is ready to complete the repair – see video no 4

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