Treatment of Flexor Tendon Reconstruction Failures : Experience with Brunelli Active Tendon Implant and Review of the Literature
Maddalena Bertolini, MD, PhD; Bruno Battiston, MD, PhD; Stefania Vanni, MD; Davide Ciclamini, MD
Hand Surg, Microsurg. Unit, Torino, Italy
Nineteen patients with failed previous flexor tendons repairs were treated with active tendon implants between 2000 and 2011. The prostheses have a metallic distal end which is to be embedded into the distal phalanx and fixed with a micro-screw, allowing early mobilization. The proximal part, which is the flexible portion, made of a polyamidic core surrounded by a silicone outer layer, has to be passed inside the pulley system and then proximally sutured to the flexor tendon. The patients were examined at 5.6 years mean follow-up by Strickland assessment and Quick DASH. We obtained 2 excellent, 3 good, 5 fair and 9 poor results using Strickland assessment. The function of the hand with Quick DASH assessment was satisfactory in 16 out of the 19 patients. We registered complications in 3 cases. In 16 cases the tendon implants were well tolerated. We can conclude that these prosthesis represent an alternative and a potentially permanent procedure in complicated flexor tendon injuries.
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