Skip to main content
SpringerLink
Log in

Extensor Tendon Reconstruction

  • Chapter
  • First Online:
Disorders of the Hand

  • 1797 Accesses

Abstract

The reconstruction of the extensor mechanism is not as simple as flexor tendon reconstruction because of the complex nature of the anatomy and kinesiology particularly within the finger. The reconstruction of the long extensors is straightforward involving either tendon buddying, tendon grafting or tendon transfer with a reasonably predictable result. The reconstruction of the extensor mechanism in the finger is far harder and much less predictable. It should always be remembered that the purpose of the hand is to hold onto objects and manipulate them. The worst thing a surgeon can do to someone’s hand is to interfere with that function and in attempting reconstruction of the extensor mechanism cause loss of flexion and so inhibit that vital function. In some situations, for example in the burnt hand, the amount of fibrosis may act as a form of elastic recoil such that attempts at extensor tendon reconstruction may be futile and inappropriate. Realistic goals are vital in this area of reconstructive surgery. Therefore it is important that the function of the hand is assessed properly by an experienced hand therapist and the surgeon should discuss with the therapists what the realistic objectives are. Far too often surgeons do surgery that may satisfy their own objectives but fail to reach the patients expectations.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Garberman SF, Diao E, Peimer CA. Mallet finger: results of early versus delayed closed treatment. J Hand Surg Am. 1994;19:850–2.

    Article  CAS  PubMed  Google Scholar 

  2. Chao JD, Sarwahi V, Da Silva YS, Rosenwasser MP, Strauch RJ. Central slip tenotomy for the treatment of chronic mallet finger: an anatomic study. J Hand Surg Am. 2004;29:216–9.

    Article  PubMed  Google Scholar 

  3. De Boeck H, Jaeken R. Treatment of chronic mallet finger deformity in children by tenodermodesis. J Pediatr Orthop. 1992;12:351–4.

    Article  PubMed  Google Scholar 

  4. Sorene E, Goodwin D. Tenodermodesis for established mallet finger deformity. Scand J Plast Reconstr Hand Surg. 2004;38:43–5.

    Article  Google Scholar 

  5. Ulker E, Cengiz A, Ozge E, et al. Repair of chronic mallet finger deformity using Miteck micro arc bone anchor. Ann Plast Surg. 2005;5:393–6.

    Google Scholar 

  6. Kardestuncer T, Bae D, Waters P. The result of tenodermodesis for severe chronic mallet finger deformity in children. J Pediatr Orthop. 2008;28:81–5.

    Article  PubMed  Google Scholar 

  7. Bowers HW, Hurst LC. Chronic mallet finger: the use of Fowler’s central slip release. J Hand Surg Am. 1978;3:373–6.

    Article  CAS  PubMed  Google Scholar 

  8. Grundberg AB, Reagan DS. Central slip tenotomy for chronic mallet finger deformity. J Hand Surg Am. 1987;12-A:545–7.

    Article  Google Scholar 

  9. Lucas GL. Fowler central slip tenotomy for old mallet deformity. Plast Reconstr Surg. 1987;80:92–4.

    Article  CAS  PubMed  Google Scholar 

  10. Houpt P, Dijkstra R, Storm Van Leeuwen JB. Fowler’s tenotomy for mallet deformity. J Hand Surg Br. 1993;18:499–500.

    Article  CAS  PubMed  Google Scholar 

  11. Kleinmman WB, Peterson DP. Oblique retinacular ligament reconstruction for chronic mallet finger deformity. J Hand Surg Am. 1984;9:399–404.

    Article  Google Scholar 

  12. Thompson JS, Littler JW, Upton J. The spiral oblique retinacular ligament. J Hand Surg Am. 1987;3:482–7.

    Article  Google Scholar 

  13. Littler JW, Eaton RG. Redistribution of forces in the correction of boutonniere deformity. J Bone Joint Surg Am. 1967;49:1267–74.

    CAS  PubMed  Google Scholar 

  14. Matev I. Transposition of the lateral slips of the aponeurosis in treatment of long-standing “boutonnière deformity” of the fingers. Br J Plast Surg. 1964;17:281–6.

    Article  CAS  PubMed  Google Scholar 

  15. Ahmad F, Pickford M. Reconstruction of the extensor central slip using a distally based flexor digitorum superficialis slip. J Hand Surg Am. 2009;34A:930–2.

    Article  Google Scholar 

  16. Curtis RM, Reid RL, Provost JM. A staged technique for the repair of the traumatic boutonniere deformity. J Hand Surg Am. 1983;8:167–71.

    Article  CAS  PubMed  Google Scholar 

  17. Le Bellec Y, Loy S, Touam C, Alnot JY, Masmejean E. Surgical treatment for boutonniere deformity of the fingers. Retrospective study of 47 patients. Chir Main. 2001;20(5):362–7.

    Article  PubMed  Google Scholar 

  18. Terrill RQ, Groves RJ. Correction of the severe nonrheumatoid chronic boutonniere deformity with a modified Matev procedure. J Hand Surg Am. 1992;17A:874–80.

    Article  Google Scholar 

  19. Ishizuki M. Traumatic and spontaneous dislocation of extensor tendon of the long finger. J Hand Surg Am. 1990;15:967–72.

    Article  CAS  PubMed  Google Scholar 

  20. Rayan GM, Murray D. Classification and treatment of closed sagittal band injuries. J Hand Surg Am. 1994;19:590–4.

    Article  CAS  PubMed  Google Scholar 

  21. Shinohara T, Nakamura R, Suzuki M, Maeda N. Extensor tendon mechanism laxity at the metacarpophalangela joint as identified by a new provocative test: predisposition to dislocation. J Hand Surg Br. 2005;30B(1):79–82.

    Article  Google Scholar 

  22. Wheeldon FT. Recurrent dislocation of extensor tendons in the hand. J Bone Joint Surg Br. 1954;36:612–7.

    PubMed  Google Scholar 

  23. Kettelkamp DB, Flatt AE, Moulds R. Traumatic dislocation of the long-finger extensor tendon: a clinical, anatomical, and biomechanical study. J Bone Joint Surg Am. 1971;53:229–40.

    CAS  PubMed  Google Scholar 

  24. McCoy FJ, Winsky AJ. Lumbrical loop operation for luxation of the extensor tendons of the hand. Plast Reconstr Surg. 1969;44:142–6.

    Article  CAS  PubMed  Google Scholar 

  25. Kilgore ES, Graham WP, Newmeyer WL, Brown LG. Correction of ulna subluxation of the extensor communis. Hand. 1975;7:272–4.

    Article  CAS  PubMed  Google Scholar 

  26. Carroll CT, Moore JR, Weiland AJ. Posttraumatic ulnar subluxation of the extensor tendons: a reconstructive technique. J Hand Surg Am. 1987;12:227–31.

    Article  PubMed  Google Scholar 

  27. Watson HK, Weinzweig J, Guidera PM. Sagittal band reconstruction. J Hand Surg Am. 1997;22A:452–6.

    Article  Google Scholar 

  28. Kang L, Carlson MG. Extensor tendon centralization at the metacarpophalangeal joint: surgical technique. J Hand Surg Am. 2010;35A:1194–7.

    Article  Google Scholar 

  29. Sundine M, Scheker LR. A comparison of immediate and staged reconstruction of the dorsum of the hand. J Hand Surg Br. 1996;21(2):216–21.

    Article  CAS  PubMed  Google Scholar 

  30. Koul AR, Patil RK, Philip V. Complex extensor tendon injuries: early active motion following single-stage reconstruction. J Hand Surg Eur Vol. 2008;33(6):753–9.

    Article  CAS  PubMed  Google Scholar 

  31. Magnussen PA, Harvey FJ, Tonkin MA. Extensor indicis proprius transfer for rupture of the extensor pollicis longus tendon. J Bone Joint Surg Br. 1990;72-B:881–3.

    Google Scholar 

  32. Schaller P, Baer W. Secondary reconstruction of extensor pollicis longus tendon. Handchir Mikrochir Plast Chir. 2003;35(6):373–6.

    Article  CAS  PubMed  Google Scholar 

  33. Pillukat T, Prommersberger KJ, van Schoonhoven J. Comparison of the results between reconstruction of the extensor pollicis longus tendon using a free interposition graft and extensor indices transposition. Handchir Mikrochir Plast Chir. 2008;40(3):160–4.

    Article  CAS  PubMed  Google Scholar 

  34. Shah MA, Buford WL, Viegas SF. Effects of extensor pollicis longus transposition and extensor indicis proprius transfer to extensor pollicis longus on thumb mechanics. J Hand Surg Am. 2003;28(4):661–8.

    Article  PubMed  Google Scholar 

  35. Germann G, Wagner H, Blome-Eberwein S, Karle B, Wittemann M. Early dynamic motion versus postoperative immobilization in patients with extensor indicis proprius transfer to restore thumb extension: a prospective randomized study. J Hand Surg Am. 2001;26(6):1111–5.

    Article  CAS  PubMed  Google Scholar 

  36. Giessler GA, Przybilski M, Germann G, Sauerbier M, Megerle K. Early free active versus dynamic extension splinting after extensor indicis proprius tendon transfer to restore thumb extension: a prospective randomized study. J Hand Surg Am. 2008;33(6):864–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Chelsea and Westminster Hospital NHS Trust, 369 Fulham Road, London, SW10 9NH, UK

    Simon Ball MA, FRCS(Tr & Orth) & Rupert Eckersley FRCS

Authors
  1. Simon Ball MA, FRCS(Tr & Orth)
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rupert Eckersley FRCS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Simon Ball MA, FRCS(Tr & Orth) .

Editor information

Editors and Affiliations

  1. Wrightington Hospital, Wigan, United Kingdom

    Ian A. Trail

  2. St George's Hospital, London, United Kingdom

    Andrew N.M. Fleming

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag London

About this chapter

Cite this chapter

Ball, S., Eckersley, R. (2015). Extensor Tendon Reconstruction. In: Trail, I., Fleming, A. (eds) Disorders of the Hand. Springer, London. https://doi.org/10.1007/978-1-4471-6560-6_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-6560-6_3

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6559-0

  • Online ISBN: 978-1-4471-6560-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation