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.