The By-Pass Extensor Tendon Transfer

1995 ◽  
Vol 20 (3) ◽  
pp. 392-397 ◽  
Author(s):  
C. OBERLIN ◽  
A. ATCHABAYAN ◽  
A. SALON ◽  
A. BHATIA ◽  
J. M. OVIEVE
Keyword(s):  
Tendon Transfer ◽  
Extensor Tendon ◽  
Tendon Graft ◽  
Middle Phalanx ◽  
Extensor Apparatus ◽  
Pip Joint ◽  
Substance Loss ◽  
Active Mobilization

A salvage technique for the treatment of substance loss of the extensor apparatus with some special features is presented. It uses the extensor indicis muscle prolonged with a tendon graft. The tendon is directly attached to the middle phalanx. After surgery, the wrist is immobilized in extension, allowing immediate active mobilization of the PIP joint. The results in five patients are satisfactory.

The extensor tendon splitting approach to the proximal interphalangeal joint: do we need to reinsert the central slip?

2009 ◽  
Vol 35 (3) ◽  
pp. 188-191 ◽  
Author(s):  
A. M. Afifi ◽  
A. Richards ◽  
A. Medoro ◽  
D. Mercer ◽  
M. Moneim
Keyword(s):  
Extensor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Joint Arthroplasty ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Dorsal Approach ◽  
Pip Joint ◽  
Central Slip ◽  
Extensor Lag

Current approaches to the proximal interphalangeal (PIP) joint have potential complications and limitations. We present a dorsal approach that involves splitting the extensor tendon in the midline, detaching the insertion of the central slip and repairing the extensor tendon without reinserting the tendon into the base of the middle phalanx. A retrospective review of 16 digits that had the approach for a PIP joint arthroplasty with a mean follow up of 23 months found a postoperative PIP active ROM of 61° (range 25–90°). Fourteen digits had no extensor lag, while two digits had an extensor lag of 20° and 25°. This modified approach is fast and simple and does not cause an extensor lag.

TREATMENT OF CONGENITAL SWAN NECK DEFORMITY WITH DYNAMIC TENODESIS OF PROXIMAL INTERPHALANGEAL JOINT

2001 ◽  
Vol 26 (2) ◽  
pp. 165-167 ◽  
Author(s):  
V. SMRÈKA ◽  
I. DYLEVSKÝ
Keyword(s):  
Tendon Transfer ◽  
Tendon Graft ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Superficialis ◽  
Middle Phalanx ◽  
Flexor Digitorum ◽  
Swan Neck Deformity

Congenital swan neck deformities in seven fingers of two patients were treated by transfer of the flexor digitorum superficialis tendon to a tendon graft which was attached the extensor aponeurosis over the middle phalanx. The tendon transfer is protected for at least 2 months by a modified Murphy splint.

The anatomy and function of Cleland’s ligaments

2013 ◽  
Vol 39 (5) ◽  
pp. 482-490 ◽  
Author(s):  
R. L. Zwanenburg ◽  
P. M. N. Werker ◽  
D. A. McGrouther
Keyword(s):  
Proximal Phalanx ◽  
Extensor Tendon ◽  
Tendon Sheath ◽  
Lateral Side ◽  
Middle Phalanx ◽  
John Cleland ◽  
Pip Joint ◽  
Fresh Frozen ◽  
The Individual ◽  
And Function

The cutaneous ligaments of the digits have been recognized by anatomists for several centuries, but the best known description is that of John Cleland. Subsequent varying descriptions of their morphology have resulted in the surgical community having an imprecise view of their structure and dynamic function. We micro-dissected 24 fresh frozen fingers to analyze the individual components of Cleland’s ligamentous system. Arising from the proximal interphalangeal (PIP) joint, proximal, and sometimes middle phalanx, we found strong ligaments that ran proximally (PIP-P) and distally (PIP-D). On each side of each finger there was a PIP-P ligament present, which passed obliquely from the lateral side of the proximal and sometimes middle phalanx towards its insertion into the skin at the level of the proximal phalanx. The distal (PIP-D) ligaments were found to pass obliquely distally on the radial and ulnar aspects of the digit towards cutaneous insertions around the middle phalanx. A similar arrangement exists more distally with fibres originating from the DIP joint and middle phalanx (the DIP-P pass obliquely proximally, and the DIP-D, distally). Each individual PIP ligament consisted of three different layers originating from fibres overlying the flexor tendon sheath, periosteum or joint capsule, and extensor expansion. Ligaments arising at the DIP joint had two layers equivalent to the anterior two layers of the proximal ligaments. Cleland’s ligaments act as skin anchors maintaining the skin in a fixed relationship to the underlying skeleton during motion and functional tasks. They also prevent the skin from ‘bagging’, protect the neurovascular bundle, and create a gliding path for the lateral slips of the extensor tendon.

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.

Extensor Tendon Rupture Due to Osteoarthritis of the Distal Radio-Ulnar Joint

1991 ◽  
Vol 16 (4) ◽  
pp. 450-453 ◽  
Author(s):  
I. OHSHIO ◽  
T. OGINO ◽  
A. MINAMI ◽  
H. KATO ◽  
A. MIYAKE
Keyword(s):  
Tendon Transfer ◽  
Tendon Rupture ◽  
Extensor Tendon ◽  
Distal Radioulnar Joint ◽  
Tendon Graft ◽  
Distal Ulna ◽  
Radioulnar Joint ◽  
Dorsal Aspect ◽  
Closed Rupture ◽  
Little Finger

Five cases of closed rupture of the finger extensor tendon due to osteoarthritis of the distal radioulnar joint were studied. Difficulty in extension began at the little finger and extended to the ring and long fingers. Pain and swelling in the dorsal aspect of the wrist preceded the tendon rupture. Osteoarthritic changes at the distal radio-ulnar joint were more severe than those at the radio-carpal and intercarpal joints. The distal end of the ulna showed the plus variant, as well as dorsal dislocation or subluxation. All patients underwent a tendon graft or tendon transfer, with excision of the distal ulna. The tendon rupture was thought to be caused mainly by friction between the displaced distal end of the ulna and osteophytes of the distal radio-ulnar joint.

Dorsally Displaced Epiphyseal Fracture of the Phalangeal Base

1996 ◽  
Vol 21 (1) ◽  
pp. 136-138 ◽  
Author(s):  
H. HASHIZUME ◽  
K. NISHIDA ◽  
D. MIZUMOTO ◽  
H. TAKAGOSHI ◽  
H. INOUE
Keyword(s):  
Articular Surface ◽  
Extensor Tendon ◽  
Type I ◽  
Collateral Ligaments ◽  
Middle Phalanx ◽  
Epiphyseal Fracture ◽  
Diagnostic Difficulties ◽  
Pip Joint ◽  
Central Slip ◽  
Salter Harris

A dorsally displaced epiphyseal fracture of the middle phalanx (Salter–Harris Type I) is described. The epiphyseal fragments were attached to the central slip of the extensor tendon and collateral ligaments. The articular surface of the PIP joint was intact and smooth. The epiphysis was reduced and fixed without cutting the central slip or the collateral ligaments 8 months after injury. This kind of fracture can occur in the PIP and DIP joints, and presents special diagnostic difficulties. Open reduction is evidently necessary to correct the displacement.

SOLITARY PERIOSTEAL CHONDROMA PRESENTING AS A SNAPPING FINGER: AN UNUSUAL LOCATION

Hand Surgery ◽  
2008 ◽  
Vol 13 (02) ◽  
pp. 51-54 ◽  
Author(s):  
Toru Yamauchi ◽  
Osamu Oshiro ◽  
Shuji Hiraoka
Keyword(s):  
Unusual Case ◽  
Correct Diagnosis ◽  
Ring Finger ◽  
Extensor Tendon ◽  
Ct Scans ◽  
Unusual Location ◽  
Periosteal Chondroma ◽  
Pip Joint

We report an unusual case of a solitary periosteal chondroma presenting as a snapping finger and pain in the ring finger in a 37-year-old man. The snapping symptom was caused by impingement of this solitary chondroma. In this case, the periosteal chondroma was detached due to a finger sprain. Thus, the solitary chondroma was impinged between basal phalanx and extensor tendon, causing the pain and snapping finger. When patients with snapping finger present, CT scans can be helpful to make a correct diagnosis. To the best of our knowledge, this condition has not been described in the PIP joint.

Girdlestone-Taylor Flexor Extensor Tendon Transfer

2004 ◽  
Vol 3 (2) ◽  
pp. 91-99 ◽  
Author(s):  
John S Kirchner ◽  
Emilio Wagner
Keyword(s):  
Tendon Transfer ◽  
Extensor Tendon
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