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Abstract:
Staged flexor tendon repair utilizing temporary silastic rod implants has proved to be an effective method for restoring the grip function of severely injuried hands. Since its inauguration by CARROLL and BASSETT in 1958 this method has been successfully practiced by numerous hand surgeons. In this review the patho-physiological principles of the development of the so-called "pseudo tendon sheath" are described. The various findings as far as the formation of the new tendon sheath is concerned, are presented. The theories about incorporation of the subsequent graft and its revascularization are described. Following a detailed description of the surgical procedure our own results with 272 silastic rod implants in 184 patients are presented. Because of the kind of patients selected for the procedure, excellent results were not obtained. However, in 62% of cases results were graded "good" and in 23%, "satisfactory", while 15% were "poor". It seems to be justified to utilize two-stage flexor tendon repair for restoring grip function in severely injured hands in spite of the considerably high technical requirements, the prolonged course of rehabilitation and consequently increased cost of treatment.