ABSTRACT
Forty-five active flexor tendon implants were evaluated after placement in scarred tendon beds of digits II through V. The implant is constructed of silicone rubber with a Dacron core, terminating in a loop proximally and a metal plate distally. Modification of the implant during the period of study has improved its reliability and longevity. The improvement in total active motion (TAM) averaged 72 degrees during implant functioning (stage I) in a group of digits that before operation were classified as 78% Boyes grade 5 (salvage). Complication rate during stage I was 11% (5 out of 45). Of the 27 digits evaluated after implant replacement by tendon autograft (stage II), there was an overall improvement in 62 degrees total active motion with 70% of digits being Boyes grade 5. Many of the complications were believed to be avoidable with experience. This study demonstrates the feasibility of an active tendon implant and the possibility of a permanent prosthesis.
Subject(s)
Fingers/surgery , Prostheses and Implants , Tendons/surgery , Adolescent , Adult , Aged , Female , Humans , Male , Methods , Middle Aged , Polyethylene Terephthalates , Postoperative Care , Postoperative Complications , Silicone ElastomersABSTRACT
Basic principles stress that the injury or surgery is not to be extended through complications resulting from a failure to control edema, poor wound care, improper splinting, or forceful exercise. Prevention of these problems in hand therapy is discussed. Close rapport between surgeon, patient, and therapist is most important to support and motivate the patient. If that motivation is demolished or even impaired, the entire course of surgery and therapy may be complicated or impaired.
