Primärversorgung komplizierter Beugesehnenverletzungen an der Hand

Abstract

Complicated flexor tendon injuries are classified into lacerations, avulsions, ruptures, and defects. They are often a challenge for hand surgeons and frequently they present unsatisfactory functional results postoperatively. Lacerations and avulsions are usually treated by pull-out sutures and suture anchors. In ruptures, the causality should be sought. Tendon-linking, transposition and tenodesis/arthrodesis are the domain of rheumatoid arthritis. The primary transplantation of tendons is rarely indicated, ideally in non-contaminated flexor tendon defects in zones III-V with an uninjured surrounding soft tissue situation. Postoperative rehabilitation programs are very the same as in normal flexor tendon injuries.

Current Concepts in the Management of Rheumatoid Hand

“…Flexor tendons ruptures are also common in patients with RA [ 24 , 25 ]. The ruptures of the FDS can be managed excising the FDS and carrying out a tenosynovectomy of the FDP, while ruptures of the FDP are more difficult to treat [ 26 ]. In case of rupture of the FDP distally to the FDS insertion, the advance and repair mechanism is possible as the proximal end is usually caught at the FDS chiasm.…”