Application of the Hunter prothesis in reconstruction of the hand flexor tendons

Abstract

Flexor tendon injuries, especially in zone 2, still present a surgical challenge, even in cases of recent injuries and early reconstruction. Today`s generally accepted attitude is, in obsolete cases, that the best functional results are achieved by reconstruction within two acts, with the silicone Hunter prosthesis used. In previous five years in our Department of Microsurgery and Reconstructive Surgery, we used this prosthesis in seven cases: six patients were male, and their average age was around 41.71 ± 13.52. In addition, there were four patients previously operated in other hospitals. Phalanx fractures, soft tissue defects, and neurovascular lesions were injuries associated with hand flexor tendons. The average time from the injury to the Hunter prosthesis application was 30.28 ± 23.96 weeks (10 to 86 weeks). When using this implant, the precise instructions of sterilization and installation procedure, given by manufacturer, must be followed. Absolute contraindications for the use of Hunter prosthesis are: presence of infection, insufficient circulation of the finger, destruction of the finger nerves and severe joint contractures. Risks during silicone implant placement are infection, fracture of prothesis, loosening, and dislocation. It is important to make the right decision when entering in this type of surgery. The final result may not often meet the patient's expectations and may worsen over time, requiring revision surgery.