Delayed reduction of avulsed FDP tendons may be complicated by difficulty in passing the tendon through the A4 or, less often, the A2 pulley. The various techniques of doing this were comprehensively reviewed recently by Kamath and Bhardwaj (2007).We present a simple solution to this problem. A 6Fr urinary catheter is passed in a retrograde direction down the empty tendon sheath to the free end of the tendon. If necessary, the catheter can be inflated to dilate pulleys, as described by Jarvis et al. (2002), and this has proven helpful in 25 of cases. A further catheter is then placed adjacent to the first and both are secured to the tip of the tendon with individual or combined core type sutures (Figs la and b). The tendon is then pulled distally through the pulleys by gentle traction on both catheters (Fig 2). We have used this technique successfully in eight cases.
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