Twenty-five-year follow-up evaluation of an active silicone/Dacron tendon interposition prosthesis: A case report

A 19-year-old man sustained a severe avulsion wound of the dominant distal forearm, dividing the radial and ulnar arteries, median and ulnar nerves, and all flexor tendons. Initial treatment consisted of revascularization. Shortly thereafter he had sural nerve grafting of the median and ulnar nerves. This was followed by insertion of a silicone/Dacron tendon interposition prosthesis to reconstruct a 4-cm deficit in the flexor profundus tendons and the flexor pollicis longus tendon. Six weeks thereafter an opposition transfer using the extensor indicis proprius and a Brand type 2 intrinsic transfer using the extensor carpi radialis longus and a plantaris tendon graft were performed. Several months later an attempt was made to remove the prosthesis. It was encased in scar tissue, however, and left in place. Evaluation 25 years later revealed that the flexor tendons and prosthesis were functioning well.