Reconstruction of the flexor pollicis longus tendon ruptured, but untreated, during infancy.

We treated 3 patients who had ruptured the flexor pollicis longus (FPL) tendon during infancy and which had not been repaired. A two-stage surgical procedure, using a silicone rod, was performed to reconstruct the tendon, and favorable thumb flexion was obtained. A favorable outcome was obtained, even if the gliding of the silicone rod had been poor after the first stage procedure. When the scar of the tendon sheath is available, it should be used as a pulley. When the tendon sheath has completely disappeared, it should be reconstructed. At the second stage of surgery, the flexor digitorum superficialis muscle of the injured finger can be used as a motor source when the muscle is conserved in good condition because its distal stump adheres to the bone. If the muscle is not in good condition, transfer of the flexor digitorum superficialis muscle of the ring finger should be performed.