Two-stage Reconstruction of Hand Extensor Tendons Using Silicon Rods.

Area of Science:

• Orthopedic Surgery
• Hand Reconstruction
• Trauma Surgery

Background:

• Extensor tendon injuries require complex reconstruction.
• A two-stage approach is often necessary for severe injuries.
• Silicone rod implants are used to facilitate tendon gliding.

Observation:

• A 16-year-old male experienced a severe right hand crush injury with dorsal skin and extensor tendon loss (digits 3-5, zones 4-6) and metacarpal fractures.
• Initial surgery included K-wire fixation of fractures and superficial circumflex iliac artery flap coverage.
• A two-stage extensor tendon reconstruction utilized silicone Hunter rod implants followed by autologous tendon grafts.

Findings:

• The patient achieved active functional finger extension within 2 years post-surgery, despite some range of motion limitations.
• The formation of pseudo-synovial sheaths by silicone rods appeared to promote tendon graft gliding.
• This technique potentially reduces tendon adhesions, shortening, and extension lag.

Implications:

• This case supports the use of silicone rod implants in staged extensor tendon reconstruction for severe hand injuries.
• The findings suggest a viable strategy for restoring finger extension and function after significant trauma.
• Further research could explore the long-term efficacy and broader application of this reconstructive approach.