scholarly journals Extensor tendon ruptures in rheumatoid wrists

2020 ◽  
Vol 30 (8) ◽  
pp. 1499-1504
Author(s):  
C. Biehl ◽  
M. Rupp ◽  
S. Kern ◽  
C. Heiss ◽  
T. ElKhassawna ◽  
...  
Keyword(s):  
Extensor Tendon ◽  
Underlying Disease ◽  
Chronic Inflammatory Disease ◽  
Functional Improvement ◽  
Patient Acceptance ◽  
Extensor Pollicis Longus ◽  
Extensor Tendons ◽  
Long Time ◽  
Healthy Control ◽  
Tendon Ruptures

Abstract Background and aims Rheumatoid arthritis is a chronic inflammatory disease. The associated involvement of hands and tendons is over 90% and impairs overall function. In the course of the disease, the joints are often operated on. During this operation, ruptures of the extensor tendons are found by chance without the patients noticing them. The aim of this retrospective study is the prevalence of extensor tendon rupture. Which tendon is destroyed most frequently? How can the functional outcome be measured after reconstruction? Materials and methods From 1572 operations on rheumatoid wrists, 61 extensor tendon ruptures were identified in 41 patients. The average time between the first rheumatic symptoms of the hand and surgery was 6.4 years. The average duration of RA was 7.8 years. 26 patients with 27 tendon reconstructions were included in the follow-up with an average postoperative duration of 4.6 years (3 to 14.2 years). Results Extensor tendons ruptures typically occurred at mechanically stressed sites. The most frequent rupture was found in the extensor pollicis longus tendon (21 tendons), followed by the small finger extensor tendon (14 tendons). A transfer was performed on 7 tendons. Fifty-five tendon lesions were sutured at other intact tendons. Free grafts were not used. The results in Clayton and QuickDASH scores were significantly different. Functional improvement was consistent with the results of tendon reconstructions in healthy control groups. Conclusion In rheumatoid patients, a rupture of an extensor tendon must be expected at 4%. Patients tolerate and compensate this damage for a long time. The function of the hand including the tendon function is the most important factor in assessing the success of the operation. The subjective patient acceptance depends on the progress of the underlying disease, postoperative care (ergotherapy, physiotherapy, orthosis) and the patients' demands.

A Comparison of Results of Extensor Tendon Repair Followed by Early Controlled Mobilisation Versus Static Immobilisation

1989 ◽  
Vol 14 (1) ◽  
pp. 18-20 ◽  
Author(s):  
J. A. Chow ◽  
S. Dovelle ◽  
L. J. Thomes ◽  
P. K. Ho ◽  
J. Saldana
Keyword(s):  
Tendon Repair ◽  
Extensor Tendon ◽  
Functional Results ◽  
Consecutive Series ◽  
Extensor Tendons ◽  
Dynamic Splinting ◽  
Tendon Surgery ◽  
Tendon Ruptures ◽  
Controlled Motion ◽  
Extensor Lag

To compare the functional results of early controlled mobilisation and static immobilisation following repair of extensor tendons, we conducted a comparative study between two centres. In one, a consecutive series of tenorrhaphy patients was treated post-operatively by the dynamic splinting technique. In the other, a consecutive group was treated by static splinting. All patients treated by dynamic splinting were graded excellent within six weeks following surgery; no tendon ruptures occurred and no secondary corrective tendon surgery was required. After static splinting, 40% were graded excellent, 31% good, 29% fair, and none poor; six fingers treated by static splintage subsequently required tenolysis. Following surgical repair of extensor tendons of the hand, patients treated by early controlled motion regain better flexion function in terms of grip strength and pulp-to-palm distance. Dynamic splinting is a more effective technique than static splinting in the prevention of extensor lag.

Tendon transfer or tendon graft for ruptured finger extensor tendons in rheumatoid hands

2009 ◽  
Vol 35 (4) ◽  
pp. 279-282 ◽  
Author(s):  
U. S. Chung ◽  
J. H. Kim ◽  
W. S. Seo ◽  
K. H. Lee
Keyword(s):  
Clinical Outcome ◽  
Tendon Transfer ◽  
Extensor Tendon ◽  
Tendon Graft ◽  
Satisfaction Scale ◽  
Patient’S Satisfaction ◽  
Extensor Tendons ◽  
Reconstruction Methods ◽  
Tendon Ruptures ◽  
The Mean

We evaluated the clinical outcome of tendon reconstruction using tendon graft or tendon transfer and the parameters related to clinical outcome in 51 wrists of 46 patients with rheumatoid arthritis with finger extensor tendon ruptures. At a mean follow-up of 5.6 years, the mean metacarpophalangeal (MP) joint extension lag was 8° (range, 0–45) and the mean visual analogue satisfaction scale was 74 (range, 10–100). Clinical outcome did not differ significantly between tendon grafting and tendon transfer. The MP joint extension lag correlated with the patient’s satisfaction score, but the pulp-to-palm distance did not correlate with patient satisfaction. We conclude that both tendon grafting and tendon transfer are reliable reconstruction methods for ruptured finger extensor tendons in rheumatoid hands.

scholarly journals Drill Penetration Injury to Extensor Tendons: A Biomechanical Analysis

Hand ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Jared M. Mahylis ◽  
Anora K. Burwell ◽  
Laura Bonneau ◽  
Lynn M. Marshall ◽  
Adam J. Mirarchi
Keyword(s):  
Cyclic Loading ◽  
Plate Fixation ◽  
Extensor Tendon ◽  
Tendon Injury ◽  
Biomechanical Analysis ◽  
Extensor Pollicis Longus ◽  
Extensor Tendons ◽  
Fresh Frozen ◽  
Increasing Cyclic Loading ◽  
Extensor Carpi Radialis

Background: Little is known about extensor tendon failure following drill injury at the time of volar plate fixation. Our goals were to analyze extensor tendon injury following simulated drill penetration, and change in tendon displacement during cyclic loading following simulated drill penetration injury. Methods: Extensor pollicis longus (EPL) and extensor carpi radialis brevis (ECRB) tendons were harvested from 9 fresh frozen cadaveric arms. Eighteen EPL and 18 ECRB samples were created from harvested tendons. Drill penetration injury was performed in either a continuous or an oscillating mode. Injured tendons were subjected to 1200 cycles at 1- to 15-kg cyclic load at a frequency of 1 Hz, and analyzed for failure at drill sites and change in displacement throughout the testing cycle. Results: Ten EPL samples and 16 ECRB samples completed testing without failure. Tendon type (ECRB, EPL), mode of injury (continuous, oscillating), and location (proximal, distal) did not affect tendon displacement during loading. A single EPL tendon failed following continuous drill penetration injury. Extensor carpi radialis brevis samples had a mean change in displacement of 2.8 (standard deviation [SD]: 1.5 mm) and 5.9 mm (SD: 4.7 mm) for oscillating and continuous modes, respectively. Six EPL samples had a mean change in displacement of 4.7 (SD: 2.7 mm) and 4.3 mm (SD: 1.8 mm) for oscillating and continuous modes, respectively. Conclusions: Complete extensor tendon failure due to drill penetration was rare. Drill mode did not affect the degree of elongation. Increasing cyclic loading of extensor tendons after drill injury caused modest extensor tendon elongation.

DELINEATION OF EXTENSOR TENDON OF THE HAND BY MRI: USEFULNESS OF "SOAP-BUBBLE" MIP PROCESSING TECHNIQUE

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 93-98 ◽  
Author(s):  
Yumiko Tsujimoto ◽  
Koji Ryoke ◽  
Nobuo Yamagami ◽  
Yuji Uchio ◽  
Shigeko Tanaka
Keyword(s):  
Spin Echo ◽  
Maximum Intensity Projection ◽  
Extensor Tendon ◽  
Processing Technique ◽  
Water Suppression ◽  
Soap Bubble ◽  
Mri Findings ◽  
Extensor Pollicis Longus ◽  
Extensor Tendons ◽  
Suppression Technique

To evaluate the capability of the "Soap-Bubble" maximum intensity projection (MIP) processing technique in visualisation of extensor tendons of the hand, 36 intact subjects and seven patients with surgically confirmed extensor tendon rupture were examined. Three-dimensional T1-weighted turbo spin echo (3DT1TFE) MRI was performed using a sensitivity encoding flex coil, followed by Soap-Bubble MIP processing. For patients with extensor tendon ruptures, MRI findings and intraoperative findings were compared. As results, with only 3DT1TFE sequence, the entire extensor tendons that run along the arch of the hand were not shown on one image, but were visualised with addition of Soap-Bubble MIP. Although delineation of the extensor pollicis longus was poor in 27/43 subjects, it was much improved by the combination of water-suppression technique. MRI findings and intraoperative findings agreed in all patients. Soap-Bubble MIP processing with addition of water-suppression technique is considered useful for visualising the extensor tendons of the hand.

The tension band principle and angular testing of extensor tendon repairs

2011 ◽  
Vol 36 (4) ◽  
pp. 297-302 ◽  
Author(s):  
J. Henderson ◽  
M. Sutcliffe ◽  
P. Gillespie
Keyword(s):  
Extensor Tendon ◽  
Tension Band ◽  
Curved Surfaces ◽  
Full Extension ◽  
Testing Apparatus ◽  
Extensor Tendons

Extensor tendons in the finger are flat and not amenable to repair by core and epitendinous sutures. Mattress sutures and Kessler repairs without epitendinous stitching are often used for extensor tendon divisions in the fingers. Except when in full extension, the finger presents a series of curved surfaces (at each joint) to the tendon. It was hypothesized that extensor tendons are subject to the ‘tension band’ principle and that they might be amenable to repair by dorsal-only epitendinous sutures. A Silfverskiöld dorsal-only repair was compared with mattress and Kessler repairs in vitro on a curvilinear testing apparatus. The epitendinous technique was found to be significantly more resistant to gapping and rupture, as well as more resistant to deformation (i.e. stiffer) than the conventional techniques.

Flexor Pollicis Longus Tendon Ruptures after Palmar Plate Fixation of Fractures of the Distal Radius

2009 ◽  
Vol 34 (4) ◽  
pp. 471-474 ◽  
Author(s):  
J. A. CASALETTO ◽  
D. MACHIN ◽  
R. LEUNG ◽  
D. J. BROWN
Keyword(s):  
Standard Treatment ◽  
Plate Fixation ◽  
Flexor Pollicis Longus ◽  
Distal Radial Fractures ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Palmar Plate ◽  
Tendon Ruptures ◽  
Flexor Pollicis Longus Tendon ◽  
Palmar Plate Fixation

Palmar plate fixation of distal radial fractures is becoming a standard treatment for this common injury. Ruptures of the extensor pollicis longus tendon have been reported in 8.6% of cases after this procedure. Although palmar plate fixation has also been associated with flexor pollicis longus (FPL) tendon problems, the majority of reported cases pre-date the use of newer anatomically precontoured locking plates. In this paper seven cases of FPL rupture are presented. This complication does not appear to be unique to one type of implant. The possible aetiologies for FPL ruptures are discussed and ways to reduce the incidence of this complication are suggested.

Tendon Entrapment in Distal Radius Fractures

2009 ◽  
Vol 34 (4) ◽  
pp. 479-482 ◽  
Author(s):  
M. OKAZAKI ◽  
K. TAZAKI ◽  
T. NAKAMURA ◽  
Y. TOYAMA ◽  
K. SATO
Keyword(s):  
Clinical Features ◽  
Distal Radius ◽  
Flexor Tendon ◽  
Extensor Tendon ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Extensor Tendons ◽  
Epiphyseal Fracture ◽  
Tendon Entrapment

We retrospectively defined the rate and clinical features of tendon entrapment in 693 consecutive patients with 701 distal radius fractures treated in a single hospital. Eight extensor tendons and one flexor tendon were entrapped. All fractures with extensor tendon entrapment were palmarly displaced (Smith type) or epiphyseal. Flexor tendon entrapment was seen in dorsally angulated (Colles type) epiphyseal fracture. The rate of tendon entrapment in acute distal radius fractures was 1.3%. Extensor tendon entrapment in palmarly displaced fractures is more common.

Rheumatoid Extensor Tendon Ruptures

Hand Clinics ◽  
1989 ◽  
Vol 5 (2) ◽  
pp. 191-202
Author(s):  
Bruce M. Leslie
Keyword(s):  
Extensor Tendon ◽  
Tendon Ruptures

scholarly journals Anatomic Association of the Proximal Fingernail Matrix to the Extensor Pollicis Longus Tendon: A Morphological and Histological Study

2018 ◽  
Vol 7 (12) ◽  
pp. 465 ◽  
Author(s):  
Patricia Palomo-López ◽  
Ricardo Becerro-de-Bengoa-Vallejo ◽  
Daniel López-López ◽  
César Calvo-Lobo ◽  
Manuel Herrera-Lara ◽  
...  
Keyword(s):  
Histological Study ◽  
Extensor Tendon ◽  
Functional Impairments ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
The Matrix ◽  
Fresh Frozen ◽  
Human Cadavers ◽  
Distal Section ◽  
Extensor Pollicis Longus Tendon

Background: Extensor tendon disorders may cause severe functional impairments, and there is a lack of knowledge about their anatomic associations with the proximal fingernail matrix. Objective: To delineate the association between the distal extensor pollicis longus tendon (EPLT) insertion and the limit of the fingernail matrix in the thumb. Methods: The limit of the fingernail matrix and the distal bony insertion of the EPLT were identified in five thumbs from fresh-frozen human cadavers. An additional five thumbs were fixed and the longitudinal thumb sections were histologically analyzed. Results: The terminal limit of the matrix and fingernail was dorsal and overlapped to the EPL tendon, which was located between the fingernail matrix and the phalanx, and extended dorsally to the distal section of the terminal phalanx in all ten thumb bodies. Conclusion: The fingernail matrix is not directly inserted into the periosteum of the dorsal section of the base to the distal phalanx, because this anatomic relationship is separated by the deep fibers of the EPLT.

Sign in / Sign up

Export Citation Format

Share Document