Injuries to the Tendons

Tendon surgery only started in the early 16th century when one differentiated between nerves and tendons as, e.g., depicted by Leonardo da Vinci, Andreas Vesalius, and Rembrandt. The breakthrough, however, was only achieved in the 20th century with the advent of improved suturing material. Horsehair, linen, cotton, and silk threads used until then only poorly glided in the tendon sheath, such that as late as 1916 it was recommended to amputate an injured fi nger so as not to impair the fi nger or indeed the whole hand. Claude Verdan was the fi rst to demonstrate a primary suture of a severed fl exor tendon in 1961. Six years later Harold Kleinert was the fi rst to successfully rejoin tendons in zone 2. In 1973, he furthermore recommended dynamic splinting of the fi nger generally leading to its full functional restitution. Later the secondary suture of the fl exor tendon was abandoned and the delayed primary suture was introduced by Buck-Gramcko et al. (1983).