On the basis of recent evidence that flexor tendon grafts may heal
without the ingrowth of vascular adhesions, eighteen autogenous donor
tendons of intrasynovial and extrasynovial origin were transferred to the
synovial sheaths in the forepaws of nine dogs, and controlled passive
mobilization was instituted early in the postoperative period. The
angiogenic responses of the tendon grafts were determined with perfusion
studies with India ink followed by cleaing of the tissues with the
Spalteholz technique at two, four, and six weeks. A consistent pattern of
neovascularization was noted in the donor tendons of extrasynovial origin.
Vascular adhesions arising from the flexor digitorum superficialis and the
tendon sheath enveloped the tendon grafts by two weeks. By six weeks, the
vascularity of the tendon grafts of extrasynovial origin appeared
completely integrated with that of the surrounding tissues. Examination of
cross sections revealed that the segments of tendon had been completely
vascularized by obliquely oriented intratendinous vessels. In contrast, the
flexor tendon grafts of intrasynovial origin healed without ingrowth of
vascular adhesions. Primary intrinsic neovascularization took place from
the proximal and, to a lesser extent, distal sites of the sutures.
Examination of cross sections revealed vessels extending through the
surface layer of the tendon graft, with small vessels penetrating the
interior of the tendons at regular intervals.