Median nerve neuropathy after flexor pollicis longus tendon reconstruction: A case report

Figure 1 Active flexion of the IP joint of the right thumb was not possible. The patient’s clinical photos presenting supination limitation and thumb interphalangeal joint flexion limitation of the right hand.

Figure 2 Intraoperative findings. A: Continuity of flexor pollicis longus (FPL) tendon was intact; B: The 4^th flexor digitorum superficialis tendon was transferred to FPL tendon using the Pulvertaft weave technique at wrist level.

Figure 3 Intraoperative findings during exploration performed after transfer surgery. A: Median nerve irritation due to tendon suture knots was found; B: All suture knots were removed.

Figure 4 Physical examination at 12 months after transfer surgery. A: Active flexion of the right thumb interphalangeal joint was 80°; B: Extension was 0°.

Figure 5 A preventive method to cover tendon suture knots using deep transverse ligament in wrist. A and B: Intraoperative clinical photos showing coverage method of tendon suture knots using the deep transverse carpal ligament dissected during approach; C: Illustration explaining this coverage method. DTCL(r): Deep transverse carpal ligament, radial leaflet; DTCL(u): Deep transverse carpal ligament, ulnar leaflet; MN: Median nerve; 4^th FDS: 4^th flexor digitorum superficialis.