Reconstruction of zone 2 extensor tendon defects with split-thickness turn-down flap: A new technique

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Reconstructive Surgery

Background:

• Tendon defects in zone 2 of the extensor mechanism present a significant reconstructive challenge.
• Tendon autografts, while used, are associated with donor site morbidities.
• Limited data exists on the efficacy of turn-down tendon flaps for upper extremity extensor tendon reconstruction.

Purpose of the Study:

• To investigate the outcomes of using a turn-down extensor tendon flap for zone 2 extensor tendon defects.
• To evaluate the safety and effectiveness of this technique in hand surgery.

Main Methods:

• Retrospective evaluation of seven fingers in six patients with zone 2 extensor tendon defects.
• Treatment involved the turn-down extensor tendon flap technique.
• Data collected included patient demographics, injury mechanism, hospital stay, complications, and 6-month postoperative outcomes.

Main Results:

• Postoperative assessments at 6 months included Michigan Hand Outcomes Questionnaire scores and range of motion (ROM) at the distal interphalangeal (DIP) joint.
• Mean passive DIP extension: 4.4°, flexion: 79.2°.
• Mean active DIP extension: 3.5°, flexion: 77.6°.
• Mean functional DIP ROM: 6.8° (minimum) to 54.8° (maximum).

Conclusions:

• The turn-down extensor tendon flap technique is a safe and effective option for reconstructing zone 2 extensor tendon defects.
• This method shows promising results for restoring function in the affected digits.
• Further research may validate its broader application in hand surgery.