Four-strand repair techniques in acute extensor tendon injuries of adult hands

Abstract

Background Extensor tendon injuries of the hand represent a common type of injuries involving the hand, which, when inadequately treated, will lead to incapacity of the hand. There are few studies on the strength of various techniques for extensor tendon injuries in comparison with the many studies concerning flexor tendon repair techniques. The application of four-strand repair technique in extensors is the concern of this study. Aim The aim was to evaluate the results of repair of recent injuries of extensor tendon in adult hands using four-strand repair technique. Patients and methods A total of 22 digits in 21 patients with simple acute open extensor tendon injuries were assessed. Primary extensor tendon repair of the digits was carried out using the four-strand technique by non-absorbable suture in all zones of that study (all extensors except injuries in fingers Verdan’s zone I, II, III, or IV). All patients were subjected to postoperative rehabilitation, with static immobilization for 3 weeks followed by controlled active exercises. Results The overall excellent and good results (satisfactory results) in the study were seen in 16 (72.7%) digits and fair or poor results were seen in 27.3%. Conclusion The use of double-modified Kessler technique had superior results than did with two-strand technique. Early passive motion, by using controlled passive mobilization after three weeks of casting, can improve results of tendon gliding in extensor tendon repair rather than the traditionally used static splinting for 6 weeks.