Evaluation of the results of management of acute extensor tendon injuries of the hand

Abstract

Objectives The aim of this study was to prospectively assess the results after primary extensor tendon repair and to analyze the factors affecting the results, such as the zone of injury, multiplicity of digits and zones affected, splint type, social class of patients, and the associated bone injury. Background Acute extensor tendon injuries of the hand is a common lesion due to the superficial nature of the extensor tendons and its adjacency to bone, which makes it more liable to injury than flexor tendons. Materials and methods During a period of 14 months, 30 hands with acute extensor tendon injuries in 29 patients (as one patient had bilateral hand affection) were studied prospectively regarding cause of injury and affected zone (s) and finger (s). Two of them were lost in follow-up postoperatively. The final results were based on 28 hands in 27 patients, where primary extensor tendon repair was carried out. The patients were followed up for an average duration of 8.5 months ranging 3-14 months and were evaluated according to Miller's scoring system. Results The final results of 46 digits with acute extensor tendon injury were reported. The excellent and good results represented 74.9% of the all final results. The best results were obtained in thumb and in zone TV and the worst results were seen in the ring finger and zone III. Multidigits and multifingers was associated with the worst results. Conclusion Multidigits and multiinjury zones involved have a poor effect on final results of extensor tendon injury. The results of zones III gave the worst results compared with other zones. More poor results were found in extensor tendons associated with bone injury. Postoperative splinting after extensor tendon repair is still under debate. From the economic point of view, a static regimen may be preferred, as it is much cheaper besides it requires little supervision by the physician.