One of the main problems in tendon surgery is the difficulty with which an acceptable degree of functional ability can be obtained after tendon repair. The very fact that the reparative process presupposes the obligatory participation of surrounding connective tissue means that, invariably, adhesions will form in every case, with subsequent diminution of the gliding mechanism.
When a tendon is divided in its paratenon structure, it will try to attach itself to whatever it encounters, or to reach out and join its opposite end in a queue de lézard fashion. Pseudopodia-like prolongations will anchor themselves into surrounding tissue and fix the cut ends. Likewise, if the extremity of a severed tendon, not in tendon sheath, is free or "unsatisfied" (Bunnell), it will by growth reach out and form adherences, much to the detriment of the patient's functional ability.
These processes are particularly apt to occur in end-to-end repair of tendons