The intriguing fate of tendon grafts in small children's hands and their results

Summary The writers have compared their results of tendon grafts on the flexor side of children's hands with their own results in adults, and with the results found in the literature for flexor tendon repair in Bunnell's "no man's land" in children as well as in adults. Several fundamental questions have been raised which still need an answer. The results found in the writers' material are in the same range as those given by other investigators for children and adults. It is necessary, however, to transpose Boyes' evaluation when used in children's hands. Although tendon grafting in children may occasionally give rise to a slight lack of growth in the grafted finger, the main conclusion is that tendon grafts are still the method of choice, also in children, in division of flexor tendons in "no man's land," unless the circumstances are extremely favourable, in which case direct suture should be tried in children.