Year Book: Long-Term Results of Extensor Tendon Repair

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Newport, ML. Blair, WF. Steyers, CM Jr. Abstract/Commentary:|1992 Year Book of Hand Surgery. Article 6-13.|Original Article:|J Hand Surg. 1990. 15-A. pp 961-966.. Background.--Little information is available regarding the quality of repair of extensor tendon injuries. In a retrospective review of the records of 62 patients with 101 digits with extensor tendon injury, the quality of outcome and factors that may affect outcome were examined. Treatment.--A primary end-to-end repair was performed in all patients, and the majority were treated with conventional static splinting postoperatively. The mean follow-up period was 5 years (range, 6 months to 20 years). Results.--Based on Miller's classification system, 47 of 91 digits (52%) had good or excellent results. Fifty-eight fingers (64%) had associated injuries, including fracture, dislocation, joint capsule damage, or flexor injury, or some combination of these, only 26 (45%) of which achieved good or excellent results compared with 21 of 33 fingers (64%) without associated injuries. The difference was significant. When injuries were classified by zones based on Verdan's classification system, more distal (zones 1-4) injuries had significantly higher percentage of fair or poor results than proximal (zones 5-8) injuries. At any joint, more fingers lost flexion than lost extension. In addition, the average degree loss of flexion was greater than the average loss of extension, particularly in zones 3 and 4. Although 95% of patients were satisfied with their functional result, 13 patients changed their jobs or sports activities because of the injury. Conclusions.--When analyzed critically, the results of extensor tendon repair do not fare nearly as well as has been described previously. Loss of flexion may be a significant complication of extensor tendon injury that may contribute significantly to overall loss of function. Methods of evaluation and treatment of extensor tendon injury should be re-evaluated.