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.

Dynamic Traction After Extensor Tendon Repair in Zones 6, 7, and 8: A Retrospective Study

1989 ◽  
Vol 14 (1) ◽  
pp. 21-22 ◽  
Author(s):  
C. D. Kerr ◽  
J. R. Burczak
Keyword(s):  
Retrospective Study ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Extensor Retinaculum ◽  
Tendon Ruptures ◽  
Full Flexion ◽  
Extensor Lag

Review of the notes of 46 extensor tendon repairs in 21 patients treated by post-operative dynamic traction without an M.P. flexion block, no tendon ruptures or extensor lag and only one digit without full flexion after a mean follow-up of seven weeks. Re-examination of 26 treated repairs in nine patients for this study demonstrated a mean T.A.M. of 259° at an average 14 months follow-up. No bow-stringing occurred because the extensor retinaculum was not excised, and no tenolyses were necessary.

Dynamic Splinting After Extensor Tendon Repair in Zones V to VII

2003 ◽  
Vol 28 (3) ◽  
pp. 224-227 ◽  
Author(s):  
S. BRÜNER ◽  
M. WITTEMANN ◽  
A. JESTER ◽  
K. BLUMENTHAL ◽  
G. GERMANN
Keyword(s):  
Retrospective Study ◽  
Surgical Complication ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Active Motion ◽  
Evaluation Systems ◽  
Dynamic Splinting ◽  
Extensor Tendon Injuries

This retrospective study evaluates a dynamic active motion protocol for extensor tendon repairs in zones V to VII. Fifty-eight patients with 87 extensor tendon injuries were examined. Using Geldmacher’s and Kleinert and Verdan’s evaluation systems, the results were graded as “excellent” and “good” in more than 94%, and as “satisfactory” in the remainder. The need for secondary tenolysis was low (6%), and no other surgical complication occurred.

scholarly journals Fixation of Acute Distal Biceps Tendon Ruptures Using Mitek Anchors: A Retrospective Study

2014 ◽  
Vol 8 (1) ◽  
pp. 52-55 ◽  
Author(s):  
M. Al-Taher ◽  
Diederick B. Wouters
Keyword(s):  
Biceps Brachii ◽  
Biceps Tendon ◽  
Tendon Repair ◽  
Functional Results ◽  
Distal Biceps Tendon ◽  
Distal Biceps ◽  
Tendon Ruptures ◽  
Biceps Tendon Repair ◽  
Dash Questionnaire

Purpose of this Study: The aim of this study was to evaluate the outcomes of surgical intra-osseous fixation of the distal tendon of the ruptured biceps brachii muscle using Mitek anchors. Materials and Methods: Between 2005 and 2011, seven patients underwent unilateral distal biceps tendon repair using Mitek anchors. All patients were men aged between 36 and 47 years. Six patients were assessed by physical examination and use of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: Surgery was performed within 3 to 17 days of rupture with a mean follow-up of 35 months. Of the six fully completed DASH questionnaires, three patients had a score of 0, and three patients had scores of 5.8, 10 and 10.8, respectively (10.1 is the mean score for the general population). Transient paraesthesias in the lateral antebrachial cutaneous nerve region occurred in two patients and one patient experienced a transient stiffness of the elbow due to scarring of the wound. No major complicatons have occurred. Conclusion: The use of Mitek anchors for the re-insertion of the ruptured distal biceps tendon proved to be a safe and effective technique with excellent functional results in our series.

Tendon Grafting for Multiple Extensor Tendon Ruptures of Fingers in Rheumatoid Hands

2002 ◽  
Vol 27 (4) ◽  
pp. 326-328 ◽  
Author(s):  
S. NAKAMURA ◽  
M. KATSUKI
Keyword(s):  
Rheumatoid Arthritis ◽  
Patient Satisfaction ◽  
Extensor Tendon ◽  
Muscle Contracture ◽  
Finger Flexion ◽  
Tendon Ruptures ◽  
Tendon Grafts ◽  
Extensor Lag

We assessed the outcome of tendon grafting of multiple finger extensor tendon ruptures in 14 patients with rheumatoid arthritis. Extensor lags improved from a preoperative mean of 33° (range, 20°–65°) to a postoperative mean of 18° (range, 0–60°). However, loss of finger flexion was observed, with a mean postoperative fingertip to palm distance of 1.6 (range: 0–7.5) cm. Patient satisfaction correlated with the fingertip to palm distance, though not with the postoperative extensor lag. Because of the loss of finger flexion which was probably due to muscle contracture, we conclude that the results of tendon grafts in this situation are unsatisfactory.

Early Controlled Motion with Dynamic Splinting versus Static Splinting for Zones III and IV Extensor Tendon Lacerations

1994 ◽  
Vol 7 (4) ◽  
pp. 232-236 ◽  
Author(s):  
Mark T. Walsh ◽  
William Rinehimer ◽  
Elaine Muntzer ◽  
Jay Patel ◽  
Michael R. Sitler
Keyword(s):  
Extensor Tendon ◽  
Dynamic Splinting ◽  
Controlled Motion

A study of the anatomy and repair strengths of porcine flexor and extensor tendons: are they appropriate experimental models?

2011 ◽  
Vol 36 (8) ◽  
pp. 663-669 ◽  
Author(s):  
W. F. Mao ◽  
Y. F. Wu ◽  
Y. L. Zhou ◽  
J. B. Tang
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Experimental Models ◽  
Extensor Tendons ◽  
Flexor Tendons

Although both porcine flexor and extensor tendons have been used in tendon repair research, no studies have specifically studied the anatomical differences and repair strengths in both types of tendons. We used 12 pig trotters to observe the anatomy of these tendons and compared the 2 mm gap and ultimate strengths of flexor and extensor tendons. There were four annular (A1, A2, A3, and A4) pulleys and one oblique pulley, which form a fibro-osseous tunnel for the flexor tendons, but the anatomy of the porcine extensor tendons was markedly different from the human flexor or extensor tendons. The diameter of flexor tendons was significantly greater than that of the extensors. The 2 mm gap and ultimate strengths of the flexor tendon with either two-strand or four-strand repairs were significantly greater than those of the extensor tendon. We conclude that the porcine flexor tendon systems are similar to those in the human, but the extensor tendons are not similar to either the flexor or extensor tendons in humans. Flexor and extensor tendons have different repair strengths which should be taken into account when interpreting findings from investigations using these tendons.

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 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.

scholarly journals Grip Lock Injury in Male Gymnasts

2009 ◽  
Vol 1 (6) ◽  
pp. 518-521 ◽  
Author(s):  
Emily M. Bezek ◽  
Ann E. VanHeest ◽  
Douglas T. Hutchinson
Keyword(s):  
Open Fracture ◽  
Case Reports ◽  
Athletic Trainers ◽  
Extensor Tendon ◽  
Tendon Injury ◽  
Ulnar Styloid Fracture ◽  
Tendon Ruptures ◽  
Extensor Lag ◽  
Extensor Tendon Injuries ◽  
Limited Duration

Background: Grip lock is a high bar injury in male gymnastics and occurs while the gymnast is rotating around the high bar. Its mechanism and treatment have been poorly documented. Study Design: Case reports. Results: One gymnast sustained an extensor tendon injury and ulnar styloid fracture and was treated nonoperatively. The second gymnast sustained open fracture of the radius and ulna with extensor tendon ruptures and was surgically treated. Both gymnasts healed and were able to return to collegiate gymnastics despite residual finger extensor lag. Conclusions: Grip lock is a physically and psychologically devastating injury on the men’s high bar that can cause forearm fractures and extensor tendon injuries at the wrist (Zone 8), which may result in residual extensor tendon lag. Injuries may be prevented with proper grip fit, appropriate maintenance of grips, and limited duration of use, as well as education of athletes, athletic trainers, and coaches

Early Active Mobilization for Extensor Tendon Injuries

1997 ◽  
Vol 22 (5) ◽  
pp. 594-596 ◽  
Author(s):  
P. SYLAIDIS ◽  
M. YOUATT ◽  
A. LOGAN
Keyword(s):  
Prospective Study ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Good Function ◽  
Dynamic Splinting ◽  
Active Mobilization ◽  
Extensor Tendon Injuries ◽  
Complex Injuries

Dynamic splinting following extensor tendon repair gives better results than static splinting, but involves cumbersome splints and recommended protocols are often complicated. We prefer controlled active mobilization of extensor tendon repairs without dynamic splinting. Six weeks after repair, excellent or good function was obtained in 22 out of 24 simple extensor tendon injuries and in 11 out of 13 complex injuries. The results of this prospective study are comparable with those reported after dynamic splinting; this regime does not require outrigger splintage and is simple to follow.

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