The use of Silastic Sheet in hand Surgery

Carstam, Nils; Eiken, Oddvar

doi:10.3109/02844317109042938

Cited by 12 publications

(4 citation statements)

References 3 publications

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“…Although patients often adapt to the synostosed position of their forearm, many are unhappy with the functional deficit created. Various techniques have been described for management of posttraumatic radioulnar synostosis including muscle interposition, 9,15 silicone rubber, 10,15,30,49 fat interposition, 24,50 absorbable gelatin sponge, 40 derotational osteotomy, 21,41 and inserting a swivel below the synostosis, 25 as well as other techniques. As an adjunct, some authors routinely prescribed the use of low-dose radiation 1,3,11,44 or antiinflammatory medication.…”

mentioning

confidence: 99%

Radioulnar synostosis after the two-incision biceps repair: A standardized treatment protocol

Sotereanos

Sarris

Chou

2004

Journal of Shoulder and Elbow Surgery

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mentioning

confidence: 99%

Radioulnar synostosis after the two-incision biceps repair: A standardized treatment protocol

Sotereanos

Sarris

Chou

2004

Journal of Shoulder and Elbow Surgery

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“…More than 40 years ago, Schneider and Leyva (1964) described the use of silicon interposition in a patient with recurrent radioulnar synostosis. Although several other authors have reported on interposition of thin silicone sheets (Carstam and Eiken, 1971; Failla et al, 1989; Vince and Miller, 1987), the results have not been consistent. Subsequently, artificial interposition materials have been replaced by biological tissue such as the fascia, fat, and muscle.…”

Section: Discussionmentioning

confidence: 64%

“…Artificial or biological interposition material can create a barrier between the raw bony surfaces. Traditionally, interposition material included silicone rubber sheets (Carstam and Eiken, 1971; Schneider and Leyva, 1964), bone wax (Jupiter and Ring, 1998), or soft tissue such as free fat (Jupiter and Ring, 1998; Yong-Hing and Tchang, 1983). However, these interposition materials may not prevent recurrence, as nonvascularized tissue may be eventually replaced by scar tissue.…”

Section: Introductionmentioning

confidence: 99%

Preventing recurrence of radioulnar synostosis with pedicled adipofascial flaps

Sonderegger¹,

Gidwani

Ross

2011

J Hand Surg Eur Vol

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The surgical treatment of post-traumatic radioulnar synostosis is difficult. Recurrence after resection alone is a concern with poor long-term maintenance of forearm rotation. We report on the use of pedicled adipofascial flaps to prevent recurrence and facilitate maintenance of movement in six adult patients with radioulnar synostosis. Five involved the proximal radioulnar joint and one the distal radioulnar joint. In four the flap was based on the radial artery and in two on the posterior interosseous artery. Mean intraoperative supination was 78° and pronation was 76°. Mean follow up was 32 months. At follow-up, mean supination was 71° and pronation was 70°. No patient had radiological recurrence of synostosis. The only complication was a transient posterior interosseous nerve palsy. Pedicled adipofascial flaps are a safe addition to resection alone which may prevent recurrence and maintain the range of forearm rotation achieved at operation.

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“… 1 , 2 , 3 , 4 , 5 , 6 , 7 Different kinds of adhesion barriers have been tested in hand surgery, both in fracture treatment and in tendon repair. The lactoferrin derivative PXL01 (Gliatech, Cleveland, OH), 8 denaturized cellulose, 9 mannose 6-phosphate, 10 Adcon-T/N, 11 hyaluronic acid, 12 polytetrafluoroethylene diffuse membrane, 13 collagen, 14 alginate, 15 amniotic fluid, 16 flexible, inert silicone elastomer sheeting, 17 amnioplastin, 18 and cellophane 19 are some examples of materials used. So far, the results have been unconvincing and none of these materials are currently widely used in a clinical setting.…”

mentioning

confidence: 99%

Dynavisc as an Adhesion Barrier in Finger Phalangeal Plate Fixation—a Prospective Case Series of 8 Patients

Kieseritzky

Rosengren

Arner

2020

Journal of Hand Surgery Global Online

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Purpose: Adhesion problems are common after plate fixation of finger phalanges and often lead to stiffness and reoperations with plate removal and tenolysis. The aim of this prospective case series was to study the effect of the adhesion barrier gel Dynavisc on total active motion (TAM), postoperative pain, and grip strength after plate fixation of phalangeal fractures. Total active motion at 3 months after surgery was the primary outcome. Methods: Eight patients with a fracture of the proximal phalanx underwent surgery with open reduction and plate fixation. The adhesion barrier Dynavisc was applied between plate and extensor tendon and between tendon and skin. Results in terms of pain, grip strength, and TAM at 2 weeks, 3 months, and 1 year after surgery were collected. Results on TAM were classified according to Page and Stern. Results: After 3 months, only 2 patients had a result classified as excellent. After 1 year, 3 patients fulfilled the criteria for an excellent result. There were no adverse events. Patients with long-standing postoperative pain had a worse outcome on TAM. Conclusions: The antiadhesive effect of Dynavisc in this prospective case series was unconvincing. Only 2 patients had an excellent result on TAM at 3 months. Because the gel is resorbed within 30 days after application, it is questionable whether the gel had a role in improvement that occurred later in the postoperative course. Larger, randomized studies would be required to show any anti-adherent effect of Dynavisc definitively in finger fracture surgery. Type of study/level of evidence: Therapeutic IV.

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The use of Silastic Sheet in hand Surgery

Cited by 12 publications

References 3 publications

Radioulnar synostosis after the two-incision biceps repair: A standardized treatment protocol

Radioulnar synostosis after the two-incision biceps repair: A standardized treatment protocol

Preventing recurrence of radioulnar synostosis with pedicled adipofascial flaps

Dynavisc as an Adhesion Barrier in Finger Phalangeal Plate Fixation—a Prospective Case Series of 8 Patients

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