silicon and Finger-Injuries

A new modification of 2-stage flexor tendon reconstruction is described. This new modification includes the utilization of the insertion of the flexor digitorum profundus tendon to develop a distal tunnel for initial placement of the silicon rod at the first stage and subsequent placement of the tendon graft at the second stage. This allows a more distal attachment of the tendon graft at the second stage of the reconstruction, to maximize tendon excursion and minimize adhesions to the volar plate of the distal interphalangeal joint. Therefore, this new modification offers better distal interphalangeal joint function and ease of second stage distal tendon graft attachment.

Topics: Finger Injuries; Humans; Postoperative Care; Prostheses and Implants; Silicon; Suture Techniques; Tendon Injuries; Tendons

The concept of tenolysis has been in existence for at least 50 years. Its function is to free tendon from posttraumatic scar tissue. To retard the recurrence of rescarring, membrane interposition between tendon and bone has been recommended. In the setting of postfracture extensor tenolysis, I prospectively employed a 3-mm section of passive Hunter rod as an interpositional material in eight consecutive patients. After an average follow-up of 23 months, the patients maintained 92 percent of operatively attained motion; only 56 percent was maintained in six patients without membrane interposition. There was no instance of rod dislocation, rod removal, or adverse silicone reaction. Extensor tenolysis with silicone membrane (Hunter rod) interposition is more predictable and enduring than tenolysis alone.

Topics: Adult; Finger Injuries; Follow-Up Studies; Fractures, Bone; Humans; Male; Prospective Studies; Prostheses and Implants; Range of Motion, Articular; Retrospective Studies; Silicon; Tendons; Tissue Adhesions

40 experimental rats had 80 silicon prostheses implanted in the hind legs for the purpose of studying the peculiarities of a capsule developing round the implant over one to twelve weeks. The silicon implant was found to help develop a smooth-walled inter-tissue capsule with a concentric pattern of collagen fibres and fibroblasts without the development of any epithelium-like lining on the inner surface of the wall. The thickness of the capsular wall becomes stabilized after six to eight weeks, never exceeding the 350 microns to 400 microns mark. The capsular wall is supplied from a concentrically growing capillary groove. The clinical material summarizes experience of 15 cases (24 fingers) of inveterate flexor tendon damage in digits II-V in the "critical" zone (II). The authors used a new method of rotated pedicled tenotransplant fixation to the distal phalanx. This permitted to dispense with plast-of-Paris immobilization, to start rehabilitation earlier, and to score excellent and good results in twelve patients (80%) (21 fingers) within five to six weeks of the second stage of tenoplasty.

Topics: Adult; Animals; Finger Injuries; Humans; Movement; Prostheses and Implants; Rats; Silicon; Tendon Injuries; Tendons

A case of room-temperature vulcanizing (RTV) silicone injection of the hand is presented, and principles of management of high-pressure hand injuries are outlined. Early debridement and decompression are urgent in the acute stage of injury. Intermediate stages require adequate coverage and mobilization, and late stages involve reconstructive procedures. As in all high-pressure hand injuries, safety measures and prevention at the industrial level are very important.

Topics: Adult; Debridement; Finger Injuries; Humans; Male; Occupational Medicine; Pressure; Silicon