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. 2020 Mar;145(3):617e-628e.
doi: 10.1097/PRS.0000000000006556.

Recent Developments Are Changing Extensor Tendon Management

Wyndell H Merritt  1 , Alison L Wong  1 , Donald H Lalonde  1
Affiliations

Recent Developments Are Changing Extensor Tendon Management

Wyndell H Merritt et al. Plast Reconstr Surg. 2020 Mar.

Abstract

Learning objectives: After reviewing this article, the participant should be able to: Start early protected movement at 3 to 5 days after surgery with relative motion extension splinting for zone 5 extensor tendon lacerations over the hand. Allow patients to resume regular activities much sooner than the conventional 3 to 4 weeks of splinting after extensor tendon repair. Improve the rehabilitation of boutonniere deformities with relative motion splinting.

Summary: This article focuses on surgery and rehabilitation of extensor tendon injuries from the proximal interphalangeal joint (boutonniere) to the wrist. Relative motion flexion and extension splinting and wide awake, local anesthesia, no tourniquet surgery have revolutionized the management of these lesions, with early protected movement, sooner return to regular activities, and improved rehabilitation. This article explains and illustrates these new advances in extensor tendon management.

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References

    1. Merritt WH. Relative motion splint: Active motion after extensor tendon injury and repair. J Hand Surg Am. 2014;39:1187–1194.
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    1. Evans RB, Burkhalter WE. A study of the dynamic anatomy of extensor tendons and implications for treatment. J Hand Surg Am. 1986;11:774–779.
    1. Howell JW, Merritt WH, Robinson SJ. Immediate controlled active motion following zone 4-7 extensor tendon repair. J Hand Ther. 2005;18:182–190.
    1. Soni P, Stern CA, Foreman KB, Rockwell WB. Advances in extensor tendon diagnosis and therapy. Plast Reconstr Surg. 2009;123:727–728.

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