CC BY-NC-ND 4.0 · Indian J Plast Surg 2016; 49(03): 322-328
DOI: 10.4103/0970-0358.197232
Original Article
Association of Plastic Surgeons of India

Silicone Foley’s catheter as an effective alternative to Hunter’s rod in staged flexor tendon reconstruction of the hand

Tawheed Ahmad
Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
,
Sheikh Adil Bashir
Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
,
Mohammad Inam Zaroo
Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
,
Adil Hafeez Wani
Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
,
Saima Rashid
Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
,
Summaira Jan
Department of Plastic and Reconstructive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 August 2019 (online)

ABSTRACT

Context: Staged flexor tendon reconstruction is most suitable treatment method for extensive zone II tendon injuries. The Hunter’s rod used in this procedure is costly and not easily available, which adds to the miseries of both patients as well as treating surgeon. Aims: The aim of this study is to evaluate the results of staged zone II flexor tendon repair using silicone Foley’s catheter as a cheaper and readily available alternative to Hunter’s rod. Settings and Design: This was a prospective study. Materials and Methods: Seventy digits in 35 patients were treated by the staged flexor tendon reconstruction using silicone Foley’s catheter in place of Hunter’s rod, and the patients were followed for an average period of 18 months. Early controlled motion exercise protocol was instituted in all cases. Results: As per the Strickland scale, total active motion obtained was excellent in 70%, good in 20%, fair in 7.1% and poor in 2.9% of patients. Conclusions: Silicone Foley’s catheter is cheaper, easily available and an effective alternative to Hunter’s rod in staged flexor tendon reconstruction procedure, yielding high rates of excellent and good results with fewer complications.

 
  • REFERENCES

  • 1 David G, Robert S. Flexor tendon injuries and reconstruction. In: Mathes SJ, Hentz VR. editors Text Book of Plastic Surgery. 2nd ed. philadelphia: Saunder Elsevier; 2006: p. 352
  • 2 Hunter JM, Salisbury RE. Flexor-tendon reconstruction in severely damaged hands. A two-stage procedure using a silicone-dacron reinforced gliding prosthesis prior to tendon grafting. J Bone Joint Surg Am 1971; 53: 829-58
  • 3 Wehbé MA, Mawr B, Hunter JM, Schneider LH, Goodwyn BL. Two-stage flexor-tendon reconstruction. Ten-year experience. J Bone Joint Surg Am 1986; 68: 752-63
  • 4 Kuran I, Ozcan H, Turan T, Sakyz D, Bas L. Searching for alternatives to silicone rods in staged tendon reconstruction. Eur J Plast Surg 1998; 21: 317-20
  • 5 Atik B, Sarici M, Kalender AM, Isik D, Aydin OE. Hunter’s technique without Hunter’s rod. Acta Orthop Belg 2012; 78: 479-83
  • 6 Bruner JM. The zig-zag volar-digital incision for flexor-tendon surgery. Plast Reconstr Surg 1967; 40: 571-4
  • 7 Mayer L, Ransohoff N. Reconstruction of the digital tendon sheath: A contribution to the physiological method of repair of damaged finger tendons. J Bone Joint Surg 1936; 18: 607-16
  • 8 Bassett CA, Carroll RE. Formation of tendon sheaths by silicone rod implants. Proceedings of American Society for Surgery of the Hand. J Bone Joint Surg Am 1963; 45: 884
  • 9 American Society for Surgery of the Hand (ASSH). Clinical Assessment Committee Report. Rosemont, IL: Churchill Livingstone; 1976
  • 10 Unglaub F, Bultmann C, Reiter A, Hahn P. Two-staged reconstruction of the flexor pollicis longus tendon. J Hand Surg Br 2006; 31: 432-5
  • 11 Smith P, Jones M, Grobbelaar A. Two-stage grafting of flexor tendons: Results after mobilisation by controlled early active movement. Scand J Plast Reconstr Surg Hand Surg 2004; 38: 220-7
  • 12 Beris AE, Darlis NA, Korompilias AV, Vekris MD, Mitsionis GI, Soucacos PN. Two-stage flexor tendon reconstruction in zone II using a silicone rod and a pedicled intrasynovial graft. J Hand Surg Am 2003; 28: 652-60
  • 13 Strickland JW. Development of flexor tendon surgery: Twenty-five years of progress. J Hand Surg Am 2000; 25: 214-35
  • 14 Viegas SF. A new modification of two-stage flexor tendon reconstruction. Tech Hand Up Extrem Surg 2006; 10: 177-80
  • 15 Frakking TG, Depuydt KP, Kon M, Werker PM. Retrospective outcome analysis of staged flexor tendon reconstruction. J Hand Surg Br 2000; 25: 168-74
  • 16 Coyle Jr MP, Leddy TP, Leddy JP. Staged flexor tendon reconstruction fingertip to palm. J Hand Surg Am 2002; 27: 581-5
  • 17 Abdul-Kader MH, Amin MA. Two-stage reconstruction for flexor tendon injuries in zone II using a silicone rod and pedicled sublimis tendon graft. Indian J Plast Surg 2010; 43: 14-20
  • 18 Sun S, Ding Y, Ma B, Zhou Y. Two-stage flexor tendon reconstruction in zone II using Hunter’s technique. Orthopedics 2010; 33: 880
  • 19 Darlis NA, Beris AE, Korompilias AV, Vekris MD, Mitsionis GI, Soucacos PN. Two-stage flexor tendon reconstruction in zone 2 of the hand in children. J Pediatr Orthop 2005; 25: 382-6
  • 20 Valenti P, Gilbert A. Two-stage flexor tendon grafting in children. Hand Clin 2000; 16: 573-8 viii
  • 21 Elliot D, Giesen T. Treatment of unfavourable results of flexor tendon surgery: Ruptured repairs, tethered repairs and pulley incompetence. Indian J Plast Surg 2013; 46: 458-71