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Extensor tendon ruptures in rheumatoid wrists.

C Biehl1,2, M Rupp3,4, S Kern4

  • 1Klinik Und Poliklinik für Unfall-, Hand- und Wiederherstellungschirurgie-Operative Notaufnahme, UKGM Universitätsklinikum Gießen Und Marburg, Rudolf-Buchheim-Str. 7, 35392, Giessen, Germany. Christoph.Biehl@chiru.med.uni-giessen.de.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|July 5, 2020
PubMed
Summary
This summary is machine-generated.

Extensor tendon ruptures occur in 4% of rheumatoid arthritis patients, often unnoticed. Reconstruction surgery can restore hand function, with outcomes comparable to healthy individuals.

Keywords:
Extensor tendonRheumatoid arthritisTendon reconstructionTendon rupturesTendon sutureWrist function

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Area of Science:

  • Orthopedics
  • Rheumatology
  • Hand Surgery

Background:

  • Rheumatoid arthritis (RA) frequently affects hand and tendons (over 90%), impairing function.
  • Extensor tendon ruptures can occur incidentally during wrist surgery in RA patients.
  • Prevalence and functional outcomes of these ruptures require investigation.

Purpose of the Study:

  • Determine the prevalence of extensor tendon ruptures in rheumatoid wrists.
  • Identify the most frequently ruptured extensor tendon.
  • Evaluate functional outcomes after tendon reconstruction in RA patients.

Main Methods:

  • Retrospective analysis of 1572 rheumatoid wrist operations.
  • Identified 61 extensor tendon ruptures in 41 patients.
  • Follow-up on 27 tendon reconstructions in 26 patients over an average of 4.6 years.

Main Results:

  • Ruptures occurred at mechanically stressed sites, most commonly the extensor pollicis longus (21 tendons) and small finger extensor (14 tendons).
  • 55 tendon lesions were sutured, 7 underwent tendon transfer; no free grafts were used.
  • Significant improvement in Clayton and QuickDASH scores post-reconstruction, comparable to healthy controls.

Conclusions:

  • Extensor tendon rupture should be anticipated in 4% of rheumatoid arthritis patients.
  • Patients often tolerate these ruptures long-term, compensating for the damage.
  • Successful surgical outcomes depend on hand function, underlying disease control, and comprehensive postoperative care.