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The muscles that move the forearms can be divided into four groups: forearm flexors, forearm extensors, forearm pronators, and forearm supinators. The flexors and extensors act on the elbow joint, while the pronators and supinators act on the radioulnar joints.
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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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Somatic spinal reflexes are rapid, involuntary muscular responses to external stimuli that involve the somatic musculature and the spinal cord.
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[Extensor tendon injuries of the thumb].

M Lenz1, C Spiegel2, M Langer3

  • 1Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland. lenzmar@web.de.

Der Unfallchirurg
|March 3, 2021
PubMed
Summary
This summary is machine-generated.

Thumb extensor tendon injuries, including the extensor pollicis longus and brevis, require specific surgical repair and aftercare based on injury location. Proper diagnosis and treatment are crucial for restoring thumb function.

Keywords:
Extensor pollicis brevis muscleExtensor pollicis longus muscleRuptureSuture techniquesTendon transfer

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Area of Science:

  • Hand Surgery
  • Orthopedic Surgery
  • Traumatology

Background:

  • Thumb extensor tendon injuries involve the extensor pollicis longus, extensor pollicis brevis, and abductor pollicis longus.
  • Open injuries necessitate tendon reconstruction, immobilization, and tailored aftercare based on injury zone.
  • Proximal injuries (T4 and beyond) require dynamic splinting, while distal injuries benefit from static splinting.

Purpose of the Study:

  • To outline the management of various thumb extensor tendon injuries.
  • To differentiate and address open vs. closed injuries.
  • To highlight the importance of considering anatomical variations and avoiding misdiagnosis.

Main Methods:

  • Review of extensor tendon anatomy and injury patterns.
  • Description of surgical reconstruction techniques for open injuries.
  • Discussion of splinting protocols (static vs. dynamic) based on injury location.
  • Emphasis on recognizing and managing extensor hood ruptures and chronic ruptures.

Main Results:

  • Open thumb extensor tendon injuries require suture repair and zone-dependent aftercare.
  • Distal injuries are managed with static splinting; proximal injuries (T4+) need dynamic treatment.
  • Extensor hood ruptures at the metacarpophalangeal joint can be misdiagnosed but require refixation.
  • Chronic closed ruptures of the extensor pollicis longus tendon necessitate tendon transfer or autograft.

Conclusions:

  • Effective management of thumb extensor tendon injuries depends on accurate diagnosis and appropriate surgical and rehabilitative strategies.
  • Understanding anatomical variations and specific injury types (open, closed, hood rupture) is key to successful outcomes.
  • Timely intervention and tailored aftercare protocols are essential for restoring thumb extensor function.