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[A clinical and experimental study on flexor tendon injury with special reference to combined two-stage tenoplasty].

In this report, the results of a long-term study of combined two-stage tenoplasty conducted as reconstructive surgery for severe injuries of the flexor tendon in zone II at the Department of Orthopaedic Surgery, Nippon Medical School, during the 10-year period between January 1971 and December 1980 will be presented. In the meantime, free tendon grafting and pedicle tendon grafting using chicken's flexor tendons were also conducted in an experimental study. Microangiography was undertaken for comparison. Clinical study: The materials consisted of 30 patients and 43 fingers. The patients included 27 males and three females ranging in age from one to 52, averaging 27.8. The follow-up period was 10 years at the maximum and one and a half years at the minimum, averaging seven years and three months. The preoperative conditions of the fingers when broken down by Boyes' criteria showed that 23 fingers were "Scar" and 20 were "Salvage". The results were classified into five categories based on the method applied by Boyes and White as follow; Excellent: 2, Good: 9, Fair: 18, Poor: 9, and Worse: 5. Thus of all the fingers, 67.5% attained Fair or better results. Experimental study: The intrinsic microcirculation within the chicken's flexor tendon was visualized with microangiography for comparative analysis in the following experimental model. In the cases in which free tendon grafting was performed after silicone rod transplantation, the intratendon microvessel pattern of the grafted tendons became nearly normal eight weeks after the transplantation. In the cases in which pedicled tendon grafting was performed after the transplantation, the microvessel pattern became nearly normal six weeks after the transplantation.