Passive gliding technique using Hunter tendon prosthesis. Stage 2: Removal of prosthesis and insertion of tendon graft. A, Graft has been sutured to proximal end of prosthesis and pulled distally through new tendon bed. Note mesentery-like attachment of new sheath visible in forearm. B, Distal anastomosis. Bunnell pull-out suture in distal end of tendon graft. C, Distal anastomosis. Complete Bunnell suture with button over fingernail. Reinforcing sutures are usually placed through stump of profundus tendon. D, Proximal anastomosis. Measuring excursion of tendon graft and selecting motor. If procedure is done with local anesthesia (see text), true amplitude of active muscle contraction can be measured. E, Proximal anastomosis graft is threaded through tendon motor muscle two or three times for added strength. F, Proximal anastomosis. Stump is “fish-mouthed” after method of Pulvertaft, tension is adjusted, and one suture is inserted as shown. Further adjustment of tension can be accomplished simply by removing and shortening or lengthening as necessary. G, Proximal anastomosis. After appropriate tension has been selected, anastomosis is completed. H, Proximal anastomosis. Technique when graft is anastomosed to common profundus tendon. SEE TECHNIQUE 66.16.