The “Transverse Intraosseous Loop Technique” (Tilt) to Re-Insert Flexor Tendons in Zone 1

Flexor tendon divisions in Zone 1 need to be re-inserted to the distal phalanx. This paper describes the Transverse Intraosseous Loop Technique (TILT) of re-inserting the profundus tendon to the distal phalanx in which an internally placed suture is looped through the bone and tendon interface. It provides a strong repair, which permits the desired tensioning and can be performed in children. Ten of 12 patients' re-insertions using this technique achieved full recovery while two developed fixed flexion contractures.