Experimental permanent artificial tendon for the hand

The aim of this study was to develop a porous silastic tube with filmy wall acting as permanent artificial tendon. Twelve mongrel dogs were used. Peronaeus longus and tibialis anticus were exposed, divided in two places, and sutured in situ; they were then covered by the silastic tube. A dog was sacrificed after 1, 2, 4, 6, 8, 10, 12, 16, 20, 24, and 44 weeks; specimens were removed. Each preparation was studied as follows: (i) gross observation and light microscopy for tendon preparations and (ii) transmission electron microscopy, scanning electron microscopy and phase microscopy for the pseudosheath. Our study showed that healing of the tendon was mainly an extrinsic mechanism and that the pseudosheath formed by the silastic tube can prevent the adhesion of the surrounding tissue; it follows that the use of an artificial tendon, including a tendon-graft coated with a silastic tube, in reconstruction of the flexor digital tendon in the hand is a feasible procedure. The appropriate porous diameter and porous distance should be studied further. Tendon gliding depends mainly upon the gliding plane between the composite body of the tendon and the loose connective tissue around it.