5. 4. 3. 2. 1.

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PONTiS TENDON REPAIR TECHNIQUE

1. Using the PONTiS stainless steel suture, make the first pass through the tendon, 1.2cm from the cut end. This passes perpendicular to the long axis of the tendon.

2. Pull the PONTiS suture through the tendon so the suture lengths are equal.

3. Cross one needle over the tendon and pass it through the tendon perpendicular to the long axis of the tendon, 0.6 cm from the cut end.

4. Starting close to the exit point, pass the needle out the cut end of the tendon so the exit point is close to the center of the tendon. Cut off the needles close to the end of the sutures.

5. With the crimp in the crimp holder, pass the two proximal sutures through the proximal opening, and pass the two distal sutures through the distal opening. The sutures are color coded.

9. 8.

7. 6.

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6. Pull the PONTiS sutures to exactly approximate the tendon ends. Place and tie an epitendonous stitch at the lateral corner of the repair. Place this suture on the side opposite from where you expect to crimp. This stitch will control rotation of the tendon.

7. Firmly tighten each PONTiS suture strand individually prior to using the crimp tool. Insert the crimp tool transverse to the tendon. The crimp tool must be completely closed until the cam-action (bottoming) is felt. The assistant should gently maintain tension on the sutures as the crimp tool is closed.

8. Cut the PONTiS sutures as close to the crimp as possible.

9. Place one or two more interrupted epitendonous stitches across the palmar surface of the repair, in order to bury the crimp. Two or three stitches are usually needed. No sutures are needed posteriorly. Take the repaired tendon through 5 or 6 excursions to ensure good motion through the pulleys.

PONTiS TENDON REPAIR TECHNIQUE