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Complex extensor tendon injuries: early active motion following single-stage reconstruction.

A R Koul¹, R K Patil, V Philip

¹Department of Plastic and Reconstructive Surgery, Medical Trust Hospital, Cochin, India.

The Journal of Hand Surgery, European Volume

|August 13, 2008

Summary

Single-stage repair for complex extensor tendon injuries in hand zones V-VII offers improved outcomes. This approach reduces hospitalization and treatment costs while enhancing early functional recovery.

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Area of Science:

Orthopedic Surgery
Hand Surgery
Reconstructive Surgery

Background:

Complex extensor tendon injuries in hand zones V-VII present significant reconstructive challenges.
Previous management often involved multi-stage procedures, potentially increasing morbidity and cost.

Purpose of the Study:

To evaluate the efficacy of single-stage repair for complex extensor tendon injuries.
To assess functional outcomes and patient morbidity associated with this approach.

Main Methods:

Retrospective evaluation of 18 patients undergoing single-stage extensor tendon reconstruction over a 2-year period.
Inclusion of complex injuries in hand zones V-VII, with 21 tendons reconstructed.
Assessment of total active motion (TAM) and grip strength at various postoperative intervals.

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Main Results:

Mean TAM achieved significant improvement by 12 weeks post-surgery (249.5 degrees).
Grip strength reached approximately 75% and 90% of the contralateral hand at 12 weeks and 6 months, respectively.
Patients requiring soft tissue cover also showed positive functional recovery.

Conclusions:

Single-stage reconstruction is a viable option for complex extensor tendon injuries.
This method appears to reduce hospitalization and treatment costs.
Early functional outcomes, including range of motion and grip strength, are favorable.