Complications - Flexor tendon suture according to Kirchmayr-Kessler

• Vascular/nerve injury
• Annular ligament injury (bow-string phenomenon)

Management

• Primary microsurgical vascular/nerve suture
• Annular ligament reconstruction

Acute Complications

• Bleeding/Hematoma
• Infection/Wound healing disorder
• Rupture of the tendon suture

Management

• In case of significant hematoma, surgical revision
• In case of infection, immediate surgical revision
• Revision with renewed tendon reconstruction

Late Complications

• Tendon adhesion with movement restriction
• Gradual dehiscence, i.e., a separation of the tendon stumps with flexion deficit due to excessive length
• CRPS (Sudeck's disease)

Management

• Tenolysis or tendon replacement surgery
• In case of scar pain/neuroma pain/neuropathic pain, a wait-and-see approach, possibly desensitization therapy
• In case of CRPS, appropriate treatment of the condition (see specialized literature)