Reconstruction of the digital pulley in the monkey using biologic and nonbiologic materials.
A-2 pulleys were replaced in the hand of the nonhuman primate; on the long/little fingers the pulleys were reconstructed with a woven nylon fabric (Nitex), and on the ring/index fingers the pulleys were reconstructed with fascia lata. The opposite unoperated hand served as a control. At 2, 3, and 6 months postoperative, the animals were killed to compare the function of the reconstructed pulleys with the control pulleys of the opposite digit. Using a tensile testing machine, two parameters, work of flexion and tendon excursion, showed that both pulley reconstructions permitted minimal tendon bow-stringing and had excellent gliding function. Both materials increased in strength over time to become stronger than the control pulley. Histologic examination showed no foreign body reaction to the Nitex; excellent fibrous ingrowth into the woven nylon was seen, which matured in time. The surface of the Nitex pulley facing the tendon developed and maintained a synovial-like gliding surface. The Nitex pulley compared favorably with the fascial pulley biomechanically and histologically; both reconstructed pulleys functioned well compared with normal pulleys.
Kain
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CC
Division of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
Manske
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PR
Reinsel
T E
TE
Rouse
A M
AM
Peterson
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WW
D000818:Animals; D001705:Bioprosthesis; D005206:Fascia Lata / Q000637:transplantation; D005385:Fingers / Q000473:pathology / Q000601:surgery*; D008253:Macaca mulatta; D009757:Nylons; D011184:Postoperative Period; D019736:Prostheses and Implants; D013710:Tendons / Q000473:pathology / Q000601:surgery*
D009757:Nylons