[Use of a silicone prosthesis in two-staged reconstructive surgery of flexor tendons in fingers]

Since the time of introduction in the sixties by Hunter from Philadelphia of temporary prosthesis of tendon which was a silicone rod reinforced with dacron it has come into regular clinical usage enabling reconstruction of large injuries of tendons of flexors of fingers--particularly in the sheath area. In the work the analysis of the remote results after two-staged reconstructive operations of tendons of flexors of fingers is presented. The clinical material includes 68 patients whom in 1982-1993 tendons were reconstructed with the above mentioned method in the Clinic of Injury Surgery of Medical Academy in Wrocław. The results of treatment were evaluated according to Buck-Gramcko scale in three groups. In group I (patients with isolated tendons injury) 28% very good, 17% good and 55% satisfactory results were achieved. In group II (patients with tendons and nerves injury) 15% very, good, 30% good, 45% satisfactory and 10% unsatisfactory results were achieved. In group III (patients with tendons, nerves and bones injury) 4% very good, 20% good 30% satisfactory and 46% unsatisfactory results were achieved. Also proportional loss of muscle strength of the operated fingers, degree of return of two-punctual feeling in case of additional injury of finger nerves were evaluated. The analysis of treatment results depending on the number of injured fingers, method of primary dressing and on the time of undertaking the secondary reconstruction was carried out. On the basis of the carried out tests and their analysis the optimal method of treatment of patients qualified for two-staged reconstructions of tendons of flexors of fingers was presented.