In ten cases, including five rod placements, four tenolyses, and one immediate tendon graft, 15 pulleys have been reconstructed using a strip of extensor retinaculum 6 to 8 cm long and 8 mm in width. Placed around the phalanx, overlapped, and sutured, the 15 mm segment formely over the fourth dorsal compartment has been positioned over the flexor tendod. The reconstruction has been shown to be stronger than the 10 figure-of-eight No. 4-0 sutures employed to perform it and capable of withstanding immediate active motion. No impairment, functional or cosmetic, of the extensor apparatus has been observed.