Clinical evaluation of spontaneous rupture of the finger extensors / 中国矫形外科杂志

[Objective]To investigate the etiology,pathological characteristic and therapeutic effect of spontaneous rupture of the finger extensors.[Method]Twelve patients were included in this research group.Eight cases were diagnosed as spontaneous rupture of the extensor pollicis long(EPL) and were repaired by transfer of the extensor indicis proprius(EIP).Three cases were spontaneous double rupture of the the ring and small finger extensors.The distal stump of the ring finger extensor was woven into the middle finger extensor and the EIP was transferred to reconstruct the extensor digiti quinti.There was one case of spontaneous triple rupture of the the middle,ring finger and small finger extensors.Transplantation of frozen allogenic extensors was utilized.[Result]The finger extensor rupture occurred after either rheumatic arthritis or distal radius fracture.The former pathological examination showed that the tenosynovitis and chronic inflammation of tendons accompanying with localized necrosis was dominant,while tendon fiber rupture played an important role in the latter.All patients achieved 100% of good results and no recurrent rupture occurred.[Conclusion]The inflammation invasion or attrition in the fracture site was a patological basis to cause spontaneous rupture of finger extensors.The EPI transposition was a reliable option to reconstruct the EPL.It is suggested that allogenic tendon transplantation be applied in the case of multiple ruptures of the extensor tendons.

A Morphological Study of the Extensor Tendons and Juncturae Tendinum on the Dorsum of the Hand / 대한정형외과학회잡지

PURPOSE: To clarify the morphological patterns of the extensor tendon and juncturae tendinum on the dorsum of the hand. MATERIALS AND METHODS: Fifty eight hands of cadavers were dissected to evaluate the morphological patterns of the extensor tendon and juncturae tendinum. RESULTS: The tendon of extensor indicis proprius and extensor digitorum communis (EDC) to the index finger arose and terminated at a single tendon. The EDC to the long finger arose as a single tendon, divided into two slips and then converged again to form a single tendon. The EDC to the ring finger arose as double tendons, divided into three or four slips and converged again into double tendons. The EDC to the little finger was usually absent (72%). The extensor digiti minimi arose and terminated as double tendons. The juncturae tendinum (JT) between the EDC tendons to the index finger and those to the long finger were of type I (thin filamentous type). The JT between EDC tendon to the long finger and those to the ring finger consisted of 16% in type I, 31% in type II (thick filamentous type) and 53% in type III (tendinous type). There were 14% of type II JT and 86% of type III JT between the ring and small fingers. CONCLUSION: A knowledge of both the usual and possible variations of the extensor tendon and the juncturae tendinum is useful in the identification and repair of these structures.