Application of the Tension Band Technique for Arthrodesis of the Forefoot and Midfoot

Numerous techniques have been described for the arthrodesis of various forefoot and midfoot joints. These techniques include the use of plates, screws, wires, staples, and Steinman pins. The ease of the dorsal approach in instituting these techniques has persuaded most orthopaedic surgeons to instrument the dorsal, or compression, side of the arthrodesis. By instrumenting the compression side, the deforming forces of the arthrodesis may cause distraction on the plantar side. The use of the tension band technique in foot arthrodeses changes the plantar distraction forces to a compressive force without necessitating the exposure of the plantar surface.

The Functional Results of Hand Replantation

Eight hands amputated at wrist or distal forearm level were replanted between 1983 and 1990. Steinman pins were used to obtain skeletal fixation at the wrist level in three patients. Secondary surgery was performed in seven patients. Six of the patients were available for review between 1.5 and 7.5 years (mean 3.6) after the injury. The functional results were assessed using the Tamai scoring system. Recovery of useful hand function has been achieved in most patients, although long-term recovery of sensibility was found to be disappointing. Despite this finding, five out of the six patients were highly satisfied with the result and four have returned to work.