RESUMEN
BACKGROUND: Different pretreatments of the tendon allograft for repairing hand tendon defect due to traumatic injuries have received much attention in the study of tissue engineering for hand surgeries.OBJECTIVE:To explore the characteristics of deep-frozen glutaraldehyde-treated tendon allograft for repairing hand tendon defect.DESIGN: A self-controlled study.SETTING:Ward of Orthopedic Department, Huizhou People's Central Hospital.PARTICIPANTS:Fifteen patients (aged 20-35 years) with 17 defected tendons were hospitalized in the Department of Orthopedics of Huizhou People's Central Hospital between January 1997 and August 2001. Among the 17 defected tendons, 8 were extensor tendons and 9 flexor tendons,with the length of defects varying from 2 to 9 cm.METHODS:The allogenic tendon grafts were obtained from young donors died in accidents or non-replantable amputated limbs due to traumatic injuries with informed consent obtained from the donors or their family members. These grafts were stored at -80 ℃ and immersed in 3.5 g/L glutaraldehyde solution before transplantation. Surgical operation was conducted following standard microsurgical procedures. According to the assessment criteria for total rang of motion (ROM) recommended by International Hand Surgery Association, the outcome of the surgically repaired hands was graded as excellent, good, acceptable and poor.MAIN OUTCOME MEASURES:Total ROM of the digits and graft rejection.RESULTS:None of the 15 patients was lost for analysis. The follow-up lasted for 8 months, during which 4 transplanted tendons had excellent, 6good, 4 acceptable and 3 poor functions, with a total effective rate of 82.36% (14/17). Neither cortical hormone nor immunosuppressants were used in these cases and no acute graft rejection or rupture of the tendons occurred.CONCLUSION: The antigenicity of the tendon allografts can be lowered after deep freezing of the grafts at -80 ℃ with preoperative glutaraldehyde treatment, which also increases the strength and tenacity of the tendons and decreases the risk for infection. The treated grafts provide a good alternative for autologous tendon graft but the complication of tendon adhesion still awaits to be tackled.