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Two-stage flexor tendon reconstruction in zone II using a silicone rod and a pedicled intrasynovial graft
Alexandros E Beris1, Nickolaos A Darlis, Anastasios V Korompilias
1University of Ioannina, School of Medicine, Department of Orthopaedic Surgery, Ioannina, Greece.
Purpose:
To evaluate the results of a modified Paneva-Holevich technique for flexor tendon reconstruction in zone II.
Methods:
Twenty patients (22 digits) with poor prognosis injuries (Boyes grade 2-5) were reconstructed. The technique included placing a silicone rod and creating a loop between the flexor digitorum profundus (FDP) and the flexor digitorum superficialis (FDS) in the first stage and reflecting the latter as a pedicled graft through the pseudosheath created around the silicone rod in the second stage.
Results:
After a follow-up period of at least 1 year (mean, 50 mo) the rate of good and excellent results was 82% according to the Buck-Gramco scale and 73% using the modified Strickland scale.
Conclusions:
These results compare favorably with those using the classic (Hunter) 2-stage reconstructions with a silicone rod and a free tendon graft. Apart from technical versatility, additional advantages of the technique include using a local intrasynovial graft, the absence of donor site morbidity, and a low rate of postreconstruction tendon ruptures and tenolysis.