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Extensor tendon injuries in children
Frank Fitoussi1, Alina Badina, Brice Ilhareborde
1Department of Orthopaedic Surgery, Robert Debre Hospital, Paris VII University, Paris, France. franck.fitoussi@wanadoo.fr
Insights
Primary extensor tendon repair in children yields excellent outcomes, but younger children and specific injury zones present higher risks for complications like extension lag.
Area of Science:
- Orthopedic Surgery
- Pediatric Hand Surgery
- Traumatology
Background:
- Retrospective analysis of pediatric extensor tendon injuries.
- Focus on primary repair in children under 15 years old.
Purpose of the Study:
- Evaluate outcomes of primary extensor tendon repair in pediatric patients.
- Identify factors influencing functional recovery after tendon repair.
Main Methods:
- Reviewed 53 digits in 50 pediatric patients with extensor tendon lacerations.
- Primary repair performed within 24 hours.
- Outcomes assessed using Total Active Motion and Miller's rating systems over a 2-year follow-up.
Main Results:
- 98% of digits achieved good/excellent results by Total Active Motion.
- 95% achieved good/excellent results by Miller's classification.
- 22% of fingers experienced extension lag or loss of flexion.
Conclusions:
- Younger children (<5 years), injuries in zones I-III, and complete lacerations negatively impacted outcomes.
- Articular involvement did not significantly affect the final results.
Introduction:
This study retrospectively analyzes primary extensor tendon repairs in children younger than 15 years.
Methods:
Exclusion criteria were skin loss, devascularization, fractures, or flexor tendon injuries. Fifty patients who had sustained extensor tendon laceration with 53 digits injured were available for review. Treatment consisted of primary repair of the extensor tendon injury within the first 24 hours. The results were assessed by means of total active motion system and by Miller's rating system. The mean follow-up was 2 years.
Results:
Although 98% of the digits were rated as good or excellent according to the total active motion system and 95% according to Miller's classification, 22% of the fingers showed extension lag or loss of flexion at the last follow-up.
Discussion:
Pejorative influencing factors were injuries in zones I, II, and III; children younger than 5 years (P < 0.05), and complete tendon laceration. Articular involvement had no significant influence on final outcome.
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