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.

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.

scholarly journals Management of Extensor Tendon Injuries

2012 ◽  
Vol 6 (1) ◽  
pp. 36-42 ◽  
Author(s):  
M Griffin ◽  
S Hindocha ◽  
D Jordan ◽  
M Saleh ◽  
W Khan
Keyword(s):  
Subcutaneous Tissue ◽  
Primary Repair ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Lateral Instability ◽  
Avulsion Fractures ◽  
Post Surgery ◽  
Human Bites ◽  
Extensor Tendon Injuries

Extensor tendon injuries are very common injuries, which inappropriately treated can cause severe lasting impairment for the patient. Assessment and management of flexor tendon injuries has been widely reviewed, unlike extensor injuries. It is clear from the literature that extensor tendon repair should be undertaken immediately but the exact approach depends on the extensor zone. Zone I injuries otherwise known as mallet injuries are often closed and treated with immobilisaton and conservative management where possible. Zone II injuries are again conservatively managed with splinting. Closed Zone III or ‘boutonniere’ injuries are managed conservatively unless there is evidence of displaced avulsion fractures at the base of the middle phalanx, axial and lateral instability of the PIPJ associated with loss of active or passive extension of the joint or failed non-operative treatment. Open zone III injuries are often treated surgically unless splinting enable the tendons to come together. Zone V injuries, are human bites until proven otherwise requires primary tendon repair after irrigation. Zone VI injuries are close to the thin paratendon and thin subcutaneous tissue which strong core type sutures and then splinting should be placed in extension for 4-6 weeks. Complete lacerations to zone IV and VII involve surgical primary repair followed by 6 weeks of splinting in extension. Zone VIII require multiple figure of eight sutures to repair the muscle bellies and static immobilisation of the wrist in 45 degrees of extension. To date there is little literature documenting the quality of repairing extensor tendon injuries however loss of flexion due to extensor tendon shortening, loss of flexion and extension resulting from adhesions and weakened grip can occur after surgery. This review aims to provide a systematic examination method for assessing extensor injuries, presentation and management of all type of extensor tendon injuries as well as guidance on mobilisation pre and post surgery.

Results of Dynamic Splintage Following Extensor Tendon Repair

1997 ◽  
Vol 22 (2) ◽  
pp. 283-287 ◽  
Author(s):  
W. Y. IP ◽  
S. P. CHOW
Keyword(s):  
Prospective Study ◽  
Evaluation System ◽  
Tendon Repair ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Power Grip ◽  
Satisfactory Method ◽  
A Prospective Study ◽  
Extensor Tendon Injuries

We report a prospective study of dynamic splintage following extensor tendon repair. Eighty-four patients with 101 extensor tendon injuries were studied. Using Dargan’s evaluation system, there were 97% excellent results for the thumb and 93% excellent and good results for the fingers. The average total active motions were 107° for thumbs and 245° for fingers. Over 80% of patients regained good power grip. Patients with associated digital fractures or with ragged lacerations had poorer results. Overall, we found that dynamic splintage was a satisfactory method after extensor repair.

Complex Extensor Tendon Injuries: Early Active Motion Following Single-Stage Reconstruction

2008 ◽  
Vol 33 (6) ◽  
pp. 753-759 ◽  
Author(s):  
A. R. KOUL ◽  
R. K. PATIL ◽  
V. PHILIP
Keyword(s):  
Extensor Tendon ◽  
Early Postoperative Period ◽  
Tendon Injuries ◽  
Single Stage ◽  
Retrospective Evaluation ◽  
Cost Of Treatment ◽  
Active Motion ◽  
Normal Hand ◽  
Total Active Motion ◽  
Extensor Tendon Injuries

This study presents a retrospective evaluation of patients managed with single-stage repair following complex extensor tendon injuries. Over a 2-year period, 21 extensor tendons were reconstructed in 18 patients with complex hand injuries in zones V–VII. All eight patients needed soft tissue cover. Active mobilisation was started in the first week. Total active motion (TAM) at 4 weeks was a mean of 159° (SD 21.57) and at 6 weeks it was 202.6° (SD 13.26). Average TAM at 8 weeks was 223.8° (SD 16.46) and 249.5° (SD 14.38) at 12 weeks. Grip strength at 12 weeks and 6 months was around 75% and 90% of the contralateral normal hand in most of the patients. Single-stage reconstruction of complex extensor tendon injuries seems to reduce morbidity in terms of hospitalisation, and reduced cost of treatment. It also helps to achieve better functional outcome in the early postoperative period.

Static Splinting of Extensor Tendon Repairs

2000 ◽  
Vol 25 (2) ◽  
pp. 180-182 ◽  
Author(s):  
T. PURCELL ◽  
P. A. EADIE ◽  
S. MURUGAN ◽  
M. O’DONNELL ◽  
M. LAWLESS
Keyword(s):  
Tendon Repair ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
Safe Method ◽  
Extensor Tendon Injuries

In a prospective review we assessed the results of extensor tendon injuries managed postoperatively with a static splint. Thirty-three patients with 44 injured digits were assessed 4 months after primary tendon repair, using the Strickland-Glogovac criteria. Patients were managed in a static splint, the duration of which was guided by the zone of injury. Four months after repair, excellent or good results were obtained in 95%. Overall it was found that static splinting was an effective and safe method of management after extensor tendon repair.

Extensor Tendon Rehabilitation a Prospective Trial Comparing Three Rehabilitation Regimes

2005 ◽  
Vol 30 (2) ◽  
pp. 175-179 ◽  
Author(s):  
N. W. BULSTRODE ◽  
N. BURR ◽  
A. L. PRATT ◽  
A. O. GROBBELAAR
Keyword(s):  
Prospective Trial ◽  
Extensor Tendon ◽  
Metacarpophalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Hand Therapy ◽  
Active Motion ◽  
Joint Mobilization ◽  
Total Active Motion ◽  
Extensor Tendon Injuries

Forty-two patients with 46 complete extensor tendon injuries were prospectively allocated to one of three rehabilitation regimes: static splintage; interphalangeal joint mobilization with metacarpophalangeal joint immobilization or; the “Norwich” regime. All 42 patients were operated on by one surgeon and assessed by one hand therapist. At 4 weeks the total active motion in the static splintage group was significantly reduced but by 12 weeks there was no difference between the regimes. There was no difference in total active motion between the repaired and uninjured hand at 12 weeks, with all patients achieving good or excellent results. However, grip strength at 12 weeks was significantly reduced compared to the uninjured hand after static splintage. There was no difference in hand therapy input between the regimes.

scholarly journals Running Interlocking Horizontal Mattress—A New Technique versus Modified Kessler in Extensor Tendon Injuries: A Comparative Study

2021 ◽  
Author(s):  
Rohit Shaju ◽  
Sunil Sharma ◽  
Kshiteej Dhull
Keyword(s):  
Tendon Repair ◽  
Early Mobilization ◽  
Extensor Tendon ◽  
Tendon Injuries ◽  
New Technique ◽  
Interventional Study ◽  
Effective Technique ◽  
Controlled Motion ◽  
A New Technique ◽  
Extensor Tendon Injuries

Abstract Introduction Pursuit for a new technique, which could be placed on flat extensor tendons and strong enough to withstand the tension forces of early mobilization to prevent stiffness, started few decades ago. We evaluated the new technique of tendon repair using running interlocking horizontal mattress (RIHM) sutures followed by early controlled motion protocol in traumatic extensor tendon injuries and compared it to modified Kessler technique. Materials and Methods We conducted a prospective randomized interventional study of 18 months’ duration, with 30 patients. A total of 103 tendons were repaired, of which 58 were repaired using modified Kessler technique and 45 were repaired using RIHM technique. Postoperatively, patients underwent the early controlled motion protocol and the results were evaluated using the criteria of Miller. Results Majority of the patients had excellent results (53.3%) and 46.67% had good results in the RIHM group while most of the patients in modified Kessler group had only fair results (80%), and only 20% had good results while none had excellent results. Conclusion RIHM suture is an easy-to-learn and effective technique for tendon repair with comparable operative duration and with better overall result than modified Kessler technique.

Extensor Tendon Repair and Reconstruction

2020 ◽  
Author(s):  
Kelly D. Ledbetter ◽  
Jeffrey B. Friedrich
Keyword(s):  
Tendon Repair ◽  
Treatment Strategies ◽  
Tendon Healing ◽  
Extensor Tendon ◽  
Operative Management ◽  
Tendon Injuries ◽  
Presenting Symptoms ◽  
Acute Injuries ◽  
And Function ◽  
Extensor Tendon Injuries

The purpose of this chapter is to review the anatomy and function of extensor tendons, the physiology of tendon healing, and general principles regarding common acute and chronic extensor tendon injuries. Acute injuries are classified according to the modified Verdan system and the presenting symptoms, physical exam findings, and treatment strategies are discussed by zone of injury. Common chronic extensor tendon injuries are discussed as they relate to the dorsal wrist's division into six discrete fibro-osseous compartments. Lastly, this chapter reviews the role of  operative vs non-operative management as well as the use of immobilization vs early protective motion in the post-operative setting. This review contains 7 figures, 1 table and 37 references. Keywords: extensor, tendon, repair, reconstruction, rehabilitation, tendonopathy, surgery, splint

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