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Updated: Dec 6, 2025

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects

A Novel Tenorrhaphy Suture Technique with Tissue Engineered Collagen Graft to Repair Large Tendon Defects

Published on: December 10, 2021

Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports.

Yusuke Miyashima¹, Takuya Uemura^2,3, Takuya Yokoi⁴

¹Department of Orthopedic Surgery, Osaka General Hospital of West Japan Railway Company, 1-2-22 Matsuzakicho, Abeno-ku, Osaka, 545-0053, Japan.

BMC Musculoskeletal Disorders

|October 11, 2020

Summary

Traumatic index extensor tendon attenuation is rare but treatable. Surgical reconstruction, often using wide-awake local anesthesia and no tourniquet (WALANT), successfully restored function in two patients.

Keywords:

Attenuation Extensor tendon rupture Index finger Pseudorupture Wide awake surgery

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Area of Science:

Orthopedic Surgery
Hand Surgery
Trauma Surgery

Background:

Closed index extensor tendon ruptures are documented, but pseudorupture from intertendinous attenuation is exceptionally rare.
This report details two non-sports-related cases of traumatic index extensor tendon attenuation mimicking complete rupture.

Observation:

Patients presented with inability to actively extend metacarpophalangeal joints after wrist flexion injuries.
Intraoperative findings revealed attenuated, stretched extensor indicis proprius and extensor digitorum communis tendons, but no complete rupture.

Findings:

Surgical reconstruction involved tendon shortening (plication/step-cut) or grafting/transfer for severe attenuation.
Successful functional recovery of index metacarpophalangeal joint extension was observed six months post-surgery.

Implications:

Wide-awake local anesthesia and no tourniquet (WALANT) is recommended for precise tendon shortening and tensioning during reconstruction.
Intraoperative assessment of voluntary finger movement is crucial for evaluating tendon elongation and damage.