Reconstruction of the extensor tendon of the hand

Please note that independent interpretation of the results is not acceptable; the information below is provided for informational purposes only.

Extensor tendon reconstruction of the hand is a surgical procedure aimed at restoring the continuity and function of an injured, ruptured or damaged extensor tendon. The procedure is intended to restore the mechanism of extension of the fingers and/or hand and improve upper-limb function. The surgical technique is selected individually, taking into account the location and type of injury, the condition of the tendon and surrounding tissues, and the time elapsed since the injury.

Indications

• complete or partial ruptures of the extensor tendons of the hand or fingers;
• traumatic injuries of the extensor tendons;
• disruption of tendon continuity with impaired finger extension;
• chronic tendon injuries with retraction or scarring;
• impaired extension of the fingers or hand caused by extensor tendon injuries;
• cases in which primary tendon repair is not possible or has not produced the expected result;
• indications established by an orthopedic trauma surgeon or a surgeon specializing in hand surgery.

Procedure

1. Preoperative assessment – the physician evaluates hand function, finger mobility and the characteristics of the injury. Imaging studies are performed when necessary to accurately determine the location and extent of the injury.
2. Selection of the surgical technique – depending on the type and duration of the injury, the condition of the tendon and surrounding tissues, the surgeon determines the reconstruction method: tendon repair, tendon transfer or use of a tendon graft.
3. Anesthesia – the procedure is performed under anesthesia, with the type determined by the anesthesiologist according to the specifics of the case.
4. Access to the affected tendon – the surgeon performs a surgical approach to the injured area and identifies the tendon ends and surrounding structures.
5. Tendon reconstruction – depending on the clinical situation, the tendon is repaired or reconstructed using the selected technique, restoring its continuity and the proper positioning of the structures.
6. Fixation and functional assessment – the reconstructed structures are secured, and the surgeon assesses the position and tension of the tendon and the corresponding movement of the fingers, within the limits of intraoperative assessment.
7. Wound closure and immobilization – the wound is closed, and the hand may be immobilized with a splint or other fixation device, according to the physician’s recommendations.
8. Postoperative period and rehabilitation – after the procedure, the patient follows recommendations regarding wound care, immobilization and the gradual initiation of rehabilitation exercises. The rehabilitation and physiotherapy program is individualized according to the type of reconstruction and the healing process.

Limitations

• recovery of tendon function takes time and requires adherence to the stages of healing;
• the outcome depends on the type and duration of the injury, its location and the condition of the tissues;
• hand and finger movements may be temporarily limited after the procedure;
• an individualized medical rehabilitation and physiotherapy program is required;
• in some cases, limitations in mobility or strength may persist;
• the final outcome cannot be guaranteed and additional treatment may be required depending on the progress of recovery.

Contraindications

• active infection in the surgical area;
• acute or decompensated conditions that increase anesthetic or surgical risk;
• severe uncorrected coagulation disorders;
• skin lesions or local tissue conditions that do not allow the procedure to be performed safely;
• other clinical situations in which the procedure needs to be temporarily postponed.

The decision to perform the procedure is made by the physician after an individual assessment of the benefits and risks.

Advantages

• restoration of the continuity of the affected tendon;
• improvement of finger and/or hand extension function;
• correction of functional impairment caused by the tendon injury;
• possibility of reconstructing complex or chronic injuries when direct repair is not possible;
• the surgical approach and technique are individually adapted to the characteristics of the injury.

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3377907/
https://www.sciencedirect.com/science/article/abs/pii/S0363502301700457
https://www.orthobullets.com/hand/6038/extensor-tendon-injuries
 

IMPORTANT!

It is very important to note that the information in this section is not intended for self-diagnosis or self-treatment. If you are experiencing pain or a worsening of a medical condition, you must consult a doctor for diagnostic investigations. Only a qualified specialist can provide an accurate diagnosis and determine the appropriate treatment.
To obtain the most precise and consistent analysis results, it is recommended to perform your tests at the same laboratory. This is because different laboratories may use different methods and measurement units for similar investigations.