Update on tendon repair

The past decade has seen some remarkable advances in the management of acute tendon repair, both flexors and extensors. New surgical techniques, such as the epitenon-first technique for flexor tendons, combined with early motion rehabilitation, pharmacologic intervention to prevent adhesions, and noninvasive imaging techniques such as MR imaging to assess repair integrity lead to one inescapable conclusion. Continued evolution in attempts to improve the overall results of tendon injury can only mean that hand surgeons have not yet reached the perfect solution in tendon repair strategy. Much progress has been made since the era of 'no man's land' when primary repair in zone II was in disfavor, but many challenges remain to be met if the 'perfect' tendon repair is to be realized.