TechniquesPulley Release and Reconstruction With Acellular Dermal Matrix After Zone 2 Flexor Tendon InjuryKurlander, David E. MD*; Swanson, Marco MD*; Tu, Leigh-Anne MD†; Kumar, Anand R. MD*,‡; Long, Tobias C. MD*,‡; Lineberry, Kyle D. MD*,‡; Khouri, Joseph S. MD*,‡Author Information Departments of *Plastic Surgery †Orthopedic Surgery, Case Western Reserve University ‡University Hospitals Cleveland Medical Center, Cleveland, OH Presented in part at the 2020 annual meeting of the American Society of Plastic Surgeons in San Francisco, CA Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Joseph S. Khouri, MD, Department of Plastic and Reconstructive Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106. E-mail: [email protected]. Techniques in Hand & Upper Extremity Surgery: June 2021 - Volume 25 - Issue 2 - p 120-122 doi: 10.1097/BTH.0000000000000311 Buy Metrics Abstract Zone 2 flexor tendon repair has been historically associated with poor outcomes, mainly due to stiffness. In an effort to minimize adhesions, accommodate flexor digitorum profundus and flexor digitorum superficialis bulk, and prevent bowstringing, we have developed a novel approach to flexor tendon repair that relies on aggressive flexor tendon pulley release and pulley reconstruction with acellular dermal matrix. This technique leverages the antiadhesive properties and high tensile strength of acellular dermal matrix to maximize gliding and prevent bowstringing. Here we describe the details of our technique and illustrate a case where this technique was employed. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.