PONTiS Flexor Tendon Repair

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  1. The PONTiS flexor tendon repair system is a 2-strand repair using 3-0 multifilament stainless steel suture
  2. As shown in the previous videos the cross lock suture attachment is completed in the proximal tendon end and the tendon is passed to the site of laceration for repair
  3. By flexing the distal joints 1cm of the distal tendon is exposed and the first pass of the suture is made perpendicular to the long axis of the tendon 1cm at this distance
  4. The rest of the distal cross lock is made in the same fashion as had been done on the proximal side and the suture ends are pulled firmly in order to flatten the cross lock on the tendon surface. Note the tendon attachment lying within the pulley system without the need for additional exposure
  5. The needles are cut off close to the end of the suture strands
  6. The crimp holder loaded with a crimp is brought into the field and the sutures are passed from opposite sides through the crimp. The suture ends are color coated
  7. Using gentle traction from both sides the tendon ends are brought together at the exact tension needed
  8. At this point a single epitendinous stitch is placed on one side of the repair to ensure perfect rotation of the tendon ends
  9. The crimp tool is carefully brought in and taking care to position it without damaging the tendon the crimp is compressed for 10 seconds. It is important to position the crimp tool exactly on the center of the crimp and to be careful not to damage the sutures
  10. The sutures are cut very short and as close to the crimp as possible
  11. A few additional epitendinous stitches are placed to cover over the crimp
  12. Note the tidy repair with the cross lock located within they pulleys
  13. It is important to take the tendon through 5 or 6 excursions to ensure good gliding through the pulley system

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