We treated 132 patients by insertion of paratenon, polyethylene, or
Silastic between a digital tendon and a bone, ligament, or fixed fascial
structure to prevent adhesions. From 1950 to 1974, autogenous paratenon was
used in thirty patients; from 1956 to 1965, polyethylene film was used in
sixty-three patients; and from 1965 to 1974, Silastic sheeting was used in
thirty-nine patients. By comparing the preoperative and postoperative
measurements of joint motion and the changes in the distance separating the
pulp of a finger from the palm during flexion, these patients were
calssified as improved, unchanged, or worse. In some areas the material
used appeared to make little difference, but in other areas one or the
other was superior. Silastic sheeting (non-reinforced) proved to be the
best material for most conditions, but it should not be employed when the
skin is of poor quality or beneath a pedicle flap, and it should not be
used adjacent to a tendon graft in an area that has recovered from an
infection. Under those circumstances, paratenon is the preferred
material.