WRIST AND HAND: TENDON RUPTURE ASSOCIATED WITH RA
Tendon Graft Reconstruction
A portion of another tendon that acts as a "bridge" is inserted between and sutured to the two ends of the ruptured tendon
Tendon Transfer
A tendon is removed from its normal distal attachment and attached at another site.
Distal ulna Lister's Tubercle Volar aspect of scaphoid
Common sites of abrasion that affect the extensors are the:
Tendon rupture
In the hand region, these are common in patients with chronic tenosynovitis associated with RA.
FPL
Most common ruptured flexor tendon
EPL
Most common ruptured tendon regardless of site
Forearm-based volar resting orthosis
Orthosis for tendon rupture
Wrist in 30° to 40° extension MP joints in 10° to 20° of flexion IP joints free
Position of wrist and hand in immobilization
Loss of function of the hand
The indication for surgery is?
Tendon Anastomosis
The ruptured tendon is sutured to an adjacent intact tendon.
Direct end-to-end repair
The two ends of the ruptured tendon are reopposed and sutured together.
Tendon Anastomosis
This is a common option at the wrist for the finger extensor tendons.
Direct end-to-end repair
This option is used only occasionally because the ends of the ruptured tendons in patients with RA are usually frayed.
True
True or False: The extensor tendons are affected far more frequently than the flexor tendons.
True
True or False: The tendon transfer does not return normal joint motion but rather improves current function.
True
True or False: Use of dynamic orthosis and early mobilization (a few days after surgery) is not typically recommended for tendon reconstruction
True
True or False: Without adequate joint mobility, the transferred or reconstructed extensor tendons become adherent, resulting in a poor outcome.