Flexor tendoplasty with a tendon prosthesis for zone II flexor tendon injuries

Objectives: We evaluated two-staged flexor tendoplasty
with tendon prosthesis in patients with flexor tendon
injuries in which conventional tendon grafting would fail
to yield an acceptable result.
Methods: We performed flexor tendoplasty with tendon
prosthesis in 37 hands of 31 patients (24 males, 7 females;
mean age 23 years; range 4-46 years). Twenty-six patients
had penetrating injuries, four had occupational injuries, and
one patient had an electric burn. Preoperatively, all patients
were evaluated according to the BoyesÕ classification. At
the first stage, a silicone prosthesis, 4-6 mm in diameter was
placed according to the patientÕs age and the recipient bed;
after 3 to 5 months, silicone prosthesis was removed and
flexor tendoplasty with a tendon graft was performed. The
results were calculated according to the StricklandÕs formula.
The mean follow-up period after the second operation
was 37 months (range 12-80 months).
R e s u l t s : The results were excellent in 11 hands
(Strickland 75-100%), good in 15 hands (50-74%), moderate
in nine hands (25-49%), and poor in two hands (0-
24%), with a mean of 58%. Tenolysis was performed in
seven patients at least four months after the second stage.
Removal of the tendon prosthesis was required in one
patient because of infection.
Conclusion: Satisfactory results can be obtained with
two-staged flexor tendoplasty with a tendon prosthesis in
patients with joint injuries restricting finger movements,
digital nerve injuries causing trophic changes in the finger,
and multiple tissue injuries.
Key words: Adhesions/surgery; finger injuries/surgery/rehabilitation;
finger joint; hand injuries/surgery; range of motion,
articular; tendon injuries/surgery/rehabilitation; tendons, paraarticular/
surgery/transplantation; thumb.