RESEARCH - Extensor tendons reconstruction using autogenous palmaris longus tendon grafting for RA patients

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J Orthop Surg. 2008; 3: 16.

Published online 2008 April 24. doi: 10.1186/1749-799X-3-16. PMCID: PMC2373777

Extensor-tendons reconstruction using autogenous palmaris longus

tendon grafting for rheumatoid arthritis patients

Po-Jung Chu,1 Hung-Maan Lee,1 Yao-Tung Hou,1 Sheng-Tsai Hung,1

Jung-Kuei Chen,1 and Jui-Tien Shih1

1Department of Orthopaedic Surgery, Taoyuan Armed Forces General

Hospital, 168, Jong-Shing Rd, Taoyuan County, Taiwan

Abstract

Background

The purpose of the study is to retrospectively review the clinical

outcome of our study population of middle-aged RA patients who had

suffered extensor-tendon rupture. We reported the outcome of

autogenous palmaris tendon grafting of multiple extensor tendons at

wrist level in 14 middle-aged rheumatoid patients.

Methods

Between Feb. 2000 to Feb. 2004, thirty-six ruptured wrist level

extensor tendons were reconstructed in fourteen rheumatoid patients

(11 women and three men) using autogenous palmaris longus tendon as a

free interposition graft. In each case, the evaluation was based on

both subjective and objective criteria, including the range of MCP

joint flexion after surgery, the extension lag at the

metacarpophalangeal joint before and after surgery, and the ability of

the patient to work.

Results and Discussion

The average of follow-up was 54.1 months (range, 40 to 72 months). The

average range of MCP joint flexion after reconstruction was 66°. The

extension lag at the metacarpophalangeal joint significantly improved

from a preoperative mean of 38° (range, 25°–60°) to a postoperative

mean of 16° (range, 0°–30°). Subjectively all patients were satisfied

with the clinical results, and achieved a return to their level of

ability before tendon rupture. We found good functional results in our

series of interposition grafting using palmaris longus to reconstruct

extensor tendon defects in the rheumatoid patients.

Conclusion

Reconstruction for multiple tendon ruptures is a salvage procedure

that is often associated with extensor lag and impairment of overall

function. Early aggressive treatment of extensor tendon reconstruction

using autogenous palmaris longus tendon as a free interposition graft

in the rheumatoid wrist is another viable option to achieve good

clinical functional result.

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The full article is here:

http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed & pubmedid=1843584\

5

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