Surgical treatment of inveterate defects of the hand II-V fingers extensors tendons in VI-VII zone

Possibilities and efficacy of secondarily restoration of inveterate defects of the extensors tendons of fingers, owing various extent, were studied in conditions of cicatricial changes in the hand back skin. There was established, that in ischemic and reperfusion damage of the hand tissues the coarse cicatricial changes in the end portions of the traumatized tendons occurs, essentially influencing surgical tactics. Optimal operative techniques, directed on the extensors tendons restoration in various extent of their defects and various severity of the soft tissues changes in the hand back were determined. There was shown the perspective character of substitution of the cicactricially transformed hand back soft tissues and significant defect of the II-V fingers extensors tendons using vascularized compound complex of tissues of the foot back flap with the tendon complex.     

Errors in the treatment of combined injury to the flexor tendons nerves of the fingers and hand]

An analysis of errors in the treatment of combined traumas of the flexor tendons and nerves of the fingers and the hand in patients admitted for the restorative therapy of the Kazan Scientific Research Institute of Orthopedics and Traumatology within the period from 1969 to 1977 is presented. All the errors are subdivided into diagnostic errors, those due to the surgical technique, and connected with the rehabilitation period. A number of organizational suggestions are set forth on the grounds of the obtained findings.     

Rupture of all the flexor tendons in the hand due to malunion of a distal radius fracture

We report the case of a patient in whom the flexor digitorum superficialis and flexor digitorum profundus tendons to the index, middle, ring and little fingers ruptured 6 years following malunion of a distal radius fracture. There was no history of rheumatoid disease. The distal ulna was displaced volarly and perforated the volar wrist capsule. There was a cumulative biological effect from chronic synovitis and mechanical compression due to the ulnar head impinging upon the normal anatomic course of the flexor tendons to the ring and little fingers. We discuss the physiopathology of this rare lesion and postulate that flexor tendon rupture to the index and middle fingers will occur on the volar surface of the radius when there is a malunion with dorsal tilt.