Abstract

AbstractA particularly trying problem for surgeons is the restoration of function of the hand after the extensor mechanism of the fingers has been lacerated. Slicing or crushing injuries may involve so much tendinous tissue that the underlying phalanx is denuded of its periosteum. Adhesions of the repaired tendon to the bone are then inevitable. We have used thin sheets of Silastic placed freely beneath the repaired tendon to prevent adhesions, but the sheeting has often curled or become displaced. Consequently, we designed this study on hands of monkeys to evaluate fixation of thin Silastic sheets to underlying denuded bone, hoping that the addition of tissue adhesive would prevent the problem of curling and displacement. We operated upon 48 fingers in eight monkeys, creating artificial dorsal hand trauma by severing the extensor after denudation of the underlying phalanx. When silicone underlays were anchored in place by isobutyl-2-cyanoacrylate, range of motion increased and adhesions of underlying tissue to tendon decreased.