Management of Complications of Extensor Tendon Injuries

Lutz, Kristina; Pipicelli, Joey G.; Grewal, Ruby

doi:10.1016/j.hcl.2014.12.006

Cited by 10 publications

(3 citation statements)

References 26 publications

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“…The goal of extensor tendon treatment is to restore function while minimizing disability [2] . Restoration of thin, pliable tissue with reliable vascularity and a gliding surface facilitates motion [3] .…”

Section: Introductionmentioning

confidence: 99%

Review of the optimal timing and technique for extensor tendon reconstruction in composite dorsal hand wounds

Lies¹,

Horowitz²,

Lee³

et al. 2019

PAR

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Aim: The management of complex dorsal hand wounds with extensor tendon loss is controversial. Treatment has focused on soft tissue coverage, but there is limited evidence comparing immediate vs. staged tendon reconstruction. This review evaluates existing literature to determine the optimal management of composite hand defects. Methods: A MEDLINE database review was performed including objective measurements such as number of operations, total active motion, grip strength, days to maximum range of motion (ROM), and return to work. Data extraction included demographics, surgical techniques, complications, and relative outcome. We compared primary and secondary staged reconstruction to correlate any significant differences in outcome and determine optimal timing and technique for extensor tendon reconstruction. We extracted information on flap types including regional and free tissue transfer with tendinous components vs. staged tendon grafts. Results: Comparison of outcomes showed that patients with immediate reconstruction had fewer operations, faster return to maximum ROM, and greater chance of returning to work. The most successful single stage flaps include the radial forearm, suitable for reconstructing one to three tendons and the dorsalis pedis for three or four tendons; however, there were significantly more complications in immediate reconstruction particularly regarding donor site morbidity. Pedicled flaps had better total active motion. The two-stage approach resulted in acceptable functional outcomes without significant complications.

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Section: Introductionmentioning

confidence: 99%

Review of the optimal timing and technique for extensor tendon reconstruction in composite dorsal hand wounds

Lies¹,

Horowitz²,

Lee³

et al. 2019

PAR

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show abstract

“…he stiffness of finger joints is a prevalent complication following surgical procedures or traumatic events. The Proximal Interphalangeal (PIP) joints are particularly prone to stiffness and often develop flexion contractures [1]. This may be due to injuries to the joint surrounding tissues, the joint, edema, and poor positioning during immobilization after surgical procedures [2].…”

Section: Introductionmentioning

confidence: 99%

Proximal Interphalangeal Joint Flexion Contracture Treatment by Serial Casting Method and the Use of Thermoplastic Tape

et al. 2019

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Flexion contractures of the Proximal Interphalangeal joint are the most frequent complications resulting from surgical procedures and traumatic events. Orthotic interventions for the treatment of contractures may include serial splinting, serial casting, dynamic or static progressive orthoses, or a combination of these orthoses. This study aimed to determine the effects of serial casting methods using thermoplastic tape in the Proximal Interphalangeal (PIP) joint flexion contracture treatment. Methods: Thirty-one patients with flexion contracture of the PIP joint (mean: 32.5°, range: 10-65°) were treated by serial casting method using thermoplastic tape. Flexion contracture, total active motion, extension lag and flexion gap were evaluated in the first session. The affected joint was casted after hand therapy interventions. Patients were requested to visit the clinic every other day for recasting and receiving exercises. Results: After one month, the mean range of flexion contracture decreased from 32.5° to 10.7°. The mean range of flexion gap decreased from 3.2 cm to 1.8 cm. The mean range of extension lag decreased from 2.04 cm to 0.86 cm, and the mean range of total active motion increased from 81.67° to 128.81°. All of the aforementioned changes were statically significant (P<0.05). Discussion: The use of thermoplastic tape for serial casting is an effective and reliable method for the treatment of PIP joint flexion contracture.

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“… 12 , 13 Several surgical techniques are available, but 6 weeks of splinting is advised after surgical treatment as it is for conservative approaches. 14 , 15 …”

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confidence: 99%

Experimental Evaluation of the Elson Test Efficiency Following Central Slip Injury

Houston

Shipley

Bilderback

et al. 2021

Journal of Hand Surgery Global Online

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Management of Complications of Extensor Tendon Injuries

Cited by 10 publications

References 26 publications

Review of the optimal timing and technique for extensor tendon reconstruction in composite dorsal hand wounds

Review of the optimal timing and technique for extensor tendon reconstruction in composite dorsal hand wounds

Proximal Interphalangeal Joint Flexion Contracture Treatment by Serial Casting Method and the Use of Thermoplastic Tape

Experimental Evaluation of the Elson Test Efficiency Following Central Slip Injury

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