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BMC Surg 2020 May 25;20(1):114. Epub 2020 May 25.

Department of Orthopaedics, The Second Affiliated Hospital of Kunming Medical University, Kunming, China.

Background: Both tibial plateau fractures and extensor apparatus injuries are serious injuries to the knee joint that generally do not occur in the same patient. We report a rare case of open tibial plateau fracture combined with quadriceps tendon rupture and complete displacement of the patella into the tibial plateau fracture.

Case Presentation: The case involved a male who was 19 years old who had been in a motorcycle accident. Read More

J Orthop Trauma 2020 Jun;34(6):e203-e207

Department of Orthopaedics, University of Rochester, Rochester, NY.

Objectives: To evaluate rates and risk factors for failed surgical repair of the knee extensor mechanism.

Design: Retrospective cohort study.

Setting: Academic medical center. Read More

Open Access Rheumatol 2020 28;12:47-54. Epub 2020 Apr 28.

Department of Special Surgery, Division of Orthopedics, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan.

Background: Spontaneous rupture of extensor pollicis longus (EPL) tendon is a rare condition often found in patients actively having regular extensive use of hands and fingers especially the thumb. In this article, we report 7 cases of spontaneous rupture of EPL tendon and investigate the associated factors and treatment outcome.

Methods: Retrospectively, the databases for the 7 cases were retrieved and studied. Read More

J Nippon Med Sch 2020 Apr 30. Epub 2020 Apr 30.

Department of Orthopedic Surgery, Nippon Medical School Hospital.

Ulnar-sided wrist pain is a common issue among athletes subjecting their wrists to forceful rotational movements. Injury to the numerous complex structures in the ulnar wrist, including the extensor carpi ulnaris (ECU) tendon and the triangular fibrocartilage complex (TFCC), can result in ulnar-sided wrist pain. Although differentiating between ECU tendinitis and TFCC injury is necessary, concurrent ECU tendon disorders and TFCC injury occur occasionally in some patients. Read More

Wounds 2020 Apr;32(4):E27-E30

University of Texas Medical Branch, Galveston, TX.

Objective: This case report explores an effective treatment modality in a medically complicated patient, with considerable wound dehiscence refractory to treatment with negative pressure wound therapy (NPWT).

Case Report: A 35-year-old woman with a past medical history of hypothyroidism, osteoporosis, and rheumatoid arthritis treated with tumor necrosis factor (TNF) alpha inhibitors and disease-modifying antirheumatic drugs presented to the clinic following right great toe arthrodesis, metatarsal neck osteotomies, extensor tendon lengthening, and capsulotomy of the second, third, fourth, and fifth toes 2 weeks prior, with wound dehiscence of the right great toe and subsequent exposure of surgical hardware, complicated by infection. At the 2-week postop, a urinary bladder matrix was placed on the wound following failed NPWT, which was in place for 10 days. Read More

Hand Surg Rehabil 2020 Apr 7. Epub 2020 Apr 7.

Department of Orthopedic Surgery, Seoul St. Mary's hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero Seocho-gu, 06591 Seoul, Republic of Korea. Electronic address:

The purpose of this study was to investigate the outcomes of extensor tendon repair involving the original stump in atraumatic extensor tendon rupture of rheumatoid wrists. For this study, 16 cases were reviewed involving 14 patients with rheumatoid arthritis. A total of 52 ruptured tendons impacted 36 fingers; 51 tendons were repaired in 35 fingers. Read More

J Hand Surg Am 2020 Mar 21. Epub 2020 Mar 21.

Wockhardt Hospital, The Umrao IMSR, Thane, Maharashtra, India.

Purpose: With nerve or tendon surgery, the results of thumb reconstruction to treat radial nerve paralysis are suboptimal. The goals of this study were to describe the anatomy of the deep branch of the posterior interosseous nerve (PIN) to the thumb extensor muscles (DBPIN), and to report the clinical results of transferring the distal anterior interosseous nerve (DAIN) to the DBPIN.

Methods: The PIN was dissected in 12 fresh upper limbs. Read More

BMC Musculoskelet Disord 2020 Mar 19;21(1):179. Epub 2020 Mar 19.

Department of Orthopaedics, First Hospital of China Medical University, 155 Nan Jing North Street, Shenyang, 110001, Liaoning, China.

Background: The incidence of rupture of the quadriceps or patellar tendon s is low, especially that of bilateral quadriceps tendon rupture, and it is generally considered a complication secondary to chronic systemic disorders. We report two rare cases of simultaneous bilateral tendon rupture affecting the extensor function of the knee in patients with chronic kidney disease who have been treated with long-term haemodialysis.

Case Presentation: Two young males with a history of chronic kidney disease who were being treated with long-term haemodialysis presented to our hospital with clinical signs of disruption of the extensor mechanism of the knee. Read More

Orthop Traumatol Surg Res 2020 May 13;106(3):503-507. Epub 2020 Mar 13.

Service d'orthopédie et de traumatologie du sport, université Sorbonne, CHU Pitié-Salpétrière, 47, boulevard de l'Hôpital, 75013 Paris, France.

Introduction: Patellar tendon ruptures make up about 5% of all extensor mechanism injuries. They mainly occur in young, athletic men who have contributing risk factors such as chronic tendinopathy. The aim of this study was to evaluate the return to sport after repair of an acute patellar tendon rupture. Read More

Injury 2020 Mar 9. Epub 2020 Mar 9.

Department of Plastic Surgery, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

Background: Soft tissue defects to the dorsum of fingers are quite demanding for the reconstructive surgeon especially in the cases that bone and extensor tendons are exposed. The purpose of our study was to describe a new adipofascial island flap by a single dorsal digital perforator (dorsal adipofascial digital artery perforator, DADAP).

Materials: Methods: In 8 patients (7 male, 1 female), 12 soft tissue defects to the dorsum of the fingers (3 index, 6 middle, 2 ring, 1 little finger), ranging from 1 × 2 cm to 2 × 4 cm, were reconstructed using the DADAP flap. Read More

J Hand Ther 2020 Mar 9. Epub 2020 Mar 9.

Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Peninsula Campus, Frankston, Australia.

Study Design: Electronic Web-based survey.

Introduction: Therapists participating in an international survey selected relative motion extension (RME) as the "most used" approach for the postoperative management of zones V and VI extensor tendon repairs. A subgroup of respondents identified RME as their preferred approach and were asked about their routine RME practices. Read More

J Hand Ther 2020 Mar 9. Epub 2020 Mar 9.

Department of Occupational Therapy, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, Victoria, Australia.

Study Design: Electronic Web-based survey.

Introduction: Evidence supports early motion over immobilization for postoperative extensor tendon repair management. Various early motion programs and orthoses are used, with no single approach recognized as superior. Read More

JPRAS Open 2020 Mar 25;23:75-79. Epub 2019 Dec 25.

Department of Plastic and Reconstructive Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.

Reconstruction of combined skin and tendon loss in an injury of the dorsum of the hand is a challenging problem because it is required to achieve adequate excursion of the tendon. We herein report our case of extensor tendon repair for a dorsal hand injury using a rolled deep temporal fascial (DTF) graft and a free temporoparietal fascial flap. The patient regained satisfactory hand function with minimal donor site morbidity. Read More

Arch Orthop Trauma Surg 2020 Apr 4;140(4):583-590. Epub 2020 Mar 4.

Department of Mechanical Engineering, TOBB University of Economics and Technology, Ankara, Turkey.

Purpose: To compare five different repair techniques for extensor tendon zone III modified Kessler (MK), double-modified Kessler (DMK), modified Kessler epitendinous (MKE), double-modified Kessler epitendinous (DMKE), and running-interlocking horizontal mattress (RIHM) in terms of shortening, stiffness, gap formation, and ultimate load to failure.

Methods: A total of 35 human cadaver fingers were randomly assigned to five suture techniques with 7 fingers each and were tested under dynamic and static loading conditions.

Results: DMK was found to be superior over MK in terms of ultimate load to failure (36 N vs. Read More

Int J Surg Case Rep 2020 6;68:96-99. Epub 2020 Feb 6.

Department of Orthopedic Surgery, Tokyo Women's Medical University, Japan.

Introduction: A volar dislocation of the metacarpophalangeal (MCP) joint of the thumb is a rare trauma, and in combination with a radial collateral ligament (RCL) injury is much rarer. We present a surgical case with a recurrent volar dislocation of the MCP joint of the thumb with RCL injury.

Presentation Of Case: A 47-year-old man was referred to our hospital in the subacute phase. Read More

Plast Reconstr Surg 2020 Mar;145(3):617e-628e

Henrico, Va.; and Halifax, Nova Scotia, and Saint John, New Brunswick, Canada From the Division of Plastic Surgery, Virginia Commonwealth University/Medical College of Virginia; Department of Plastic Surgery, University of Virginia; Division of Plastic Surgery, Queen Elizabeth II Health Sciences Center; and Dalhousie University.

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. Read More

J Hand Surg Am 2020 May 21;45(5):418-426. Epub 2020 Feb 21.

Center of Biological and Health Sciences, Department of Neurosurgery, University of the South of Santa Catarina (Unisul), Tubarão; Department of Orthopedic Surgery, Governador Celso Ramos Hospital, Florianópolis, SC, Brazil. Electronic address:

Purpose: With radial nerve lesions, the results of nerve transfers and how they objectively compare with the outcomes of tendon transfers remain unstudied. We compared the results after nerve transfer in patients with less than 12 months since radial nerve injury with the results after tendon transfer in patients not eligible for nerve surgery because of longstanding paralysis (minimum of 15 months).

Methods: In 14 patients with radial nerve lesions incurred less than 12 months previously, we transferred the anterior interosseous nerve to the nerve of the extensor carpi radialis brevis (ECRB), while the nerve to the flexor carpi radialis was transferred to the posterior interosseous nerve. Read More

Hand Surg Rehabil 2020 Feb 20. Epub 2020 Feb 20.

Ankara University, Faculty of Veterinary Medicine, Department of Biostatistics, Ziraat, Şht. Ömer Halisdemir Blv, 06110 Altındağ, Ankara, Turkey.

Splinting how the hand can be used in daily life. Therefore, earlier splint removal is thought to improve functional recovery. The aim of our study was to assess the outcomes of patients who removed their splint and started using their hand earlier and compare them to patients who received routine care. Read More

J Hand Surg Am 2020 Feb 13. Epub 2020 Feb 13.

The Indiana Hand to Shoulder Center Indianapolis, Indianapolis, IN.

Purpose: Tendon reconstruction is frequently required under conditions of tendon deficiency. The authors sought a technique that could obviate the need for tendon harvest yet meet the minimum load of 45 N required for an early active motion protocol. This study was designed to determine the ideal suture construct utilizing the tendon with Z-lengthening (TWZL) technique. Read More

Orthop Traumatol Surg Res 2020 Apr 12;106(2):307-310. Epub 2020 Feb 12.

Services d'orthopédie 1 et 2, unité de chirurgie de la main, CRHU de Tours, 37044 Tours cedex, France.

Background: Nerve repair is the gold standard for treatment of radial palsy. In case of failure or contraindication, palliative techniques using tendon transfers provide good results. However, wrist extension frequently shows radial deviation, impairing grip strength. Read More

Fed Pract 2020 Jan;37(1):33-37

is the Section Chief, Plastic Surgery; and is the Occupational Therapy Supervisor and a Certified Hand Therapist; both at Malcom Randall VA Medical Center in Gainesville, Florida. Loretta Coady-Fariborzian is a Clinical Associate Professor at the University of Florida in Gainesville.

An innovative application of a hand extensor tendon repair protocol was applied by the hand therapy service to toe extensors when the hand surgery service was called in to repair toe extensor lacerations. Read More

Knee 2020 Mar 1;27(2):598-606. Epub 2020 Feb 1.

Salford Royal NHS Foundation Trust, Salford, UK.

Background: Patellar tendon rupture is an infrequent and debilitating condition, which if left untreated, is complicated by quadriceps contracture and patella alta. This results in reduced function of the knee extensor mechanism including extension lag, reduced range of motion (ROM), chronic knee pain, and frequent falls. Early primary repair has good results in most cases and is performed by opposing and suturing the tendon ends. Read More

Case Rep Orthop 2020 3;2020:2759281. Epub 2020 Jan 3.

Department of Orthopaedic Surgery and Rehabilitation, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Extensor tendon repairs, although common, can be difficult injuries to treat. Their treatment is tailored to the zone of the hand that is affected since varying biomechanical forces are applied to the tendon at each zone. Prompt treatment is necessary to prevent potential complications associated with these injuries. Read More

J Neurosurg 2020 Jan 17:1-7. Epub 2020 Jan 17.

1Department of Neurosurgery, Center of Biological and Health Sciences, University of the South of Santa Catarina (Unisul), Tubarão.

Objective: The authors describe the anatomy of the motor branches of the pronator teres (PT) as it relates to transferring the nerve of the extensor carpi radialis brevis (ECRB) to restore wrist extension in patients with radial nerve paralysis. They describe their anatomical cadaveric findings and report the results of their nerve transfer technique in several patients followed for at least 24 months postoperatively.

Methods: The authors dissected both upper limbs of 16 fresh cadavers. Read More

Arthrosc Tech 2019 Oct 19;8(10):e1163-e1169. Epub 2019 Sep 19.

Trauma Surgery Center, National Institute of Traumatology and Orthopedics of Brazil, Rio de Janeiro, RJ, Brazil.

The extensor mechanism provides active knee joint extension and stability of the patellofemoral joint. Rupture of the quadriceps tendon, although uncommon, is therefore associated with impairment in knee joint stability and, thus, requires surgical repair. Although various techniques provide excellent clinical outcomes for acute rupture, treatment of chronic rupture remains clinically challenging. Read More

Clin Anat 2020 Jan 1. Epub 2020 Jan 1.

Department of Hand Surgery, Wuxi Hand Surgery Hospital, Wuxi, Jiangsu, China.

Introduction: Soft-tissue defects on the dorsal hand accompanied by exposed bone and tendon remain a challenge for plastic surgeons. The purpose of this study was to observe the morphological characteristics of the dorsal carpal perforators in the wrist and to design a V-Y advancement flap based on the dorsal carpal perforators.

Materials And Methods: Thirty cadaveric hand specimens were dissected to observe the origin, course, branches, and anastomoses of the dorsal carpal perforators, and a V-Y advancement flap was designed based on these perforators. Read More

J Am Acad Orthop Surg Glob Res Rev 2019 Nov 4;3(11). Epub 2019 Nov 4.

Department of Orthopaedics, West Virginia University, Morgantown, WV.

Prescribing opioids for postoperative pain has increased steadily, and hand surgery has been no exception. Current hand surgery literature does not describe the efficacy of pain self-management postoperatively. The purpose of this study is to describe our experience with over-the-counter (OTC), narcotic-free, postoperative pain management. Read More

Acta Biomed 2019 12 5;90(12-S):202-206. Epub 2019 Dec 5.

SSD Ortopedia e Traumatologia , Ospedale Oglio Po, Casalmaggiore (CR).

Background And Aim Of The Work: Extensor tendon injuries of the foot in children represent a rare foot injury. We report a case of a 9 year-old male who suffered of a traumatic wound laceration in the distal third of the right leg with a glass the day before in another country, getting a combined injury of tibialis anterior (TA), extensor hallucis longus (EHL) and extensor digitorum longus (EDL).

Methods: After an initial clinical and radiological evaluation, antibiotic prophylaxis was immediately started. Read More

Case Rep Orthop 2019 11;2019:4695282. Epub 2019 Nov 11.

Temple University Hospital Department of Orthopaedics and Sports Medicine, USA.

The unique case of a rare 3-level extensor mechanism failure in a 28-year-old male, involving a tibial tubercle avulsion fracture, a patellar tendon avulsion off the tibial tubercle fragment, and a severely comminuted patella fracture, and the surgical technique required to repair such an injury is presented. Focus is spent on the unique repair of a tendon injury when both proximal and distal bony attachments are damaged. Trifocal knee extensor mechanism is a rare clinical entity with minimal literature available-to date, this injury has only been reported in a retrospective review of combat-related injuries in military personnel. Read More

J Orthop Surg Res 2019 Dec 2;14(1):410. Epub 2019 Dec 2.

Sibley School of Mechanical and Aerospace Engineering, College of Engineering, Cornell University, Ithaca, NY, USA.

Background: Tendon injuries are common musculoskeletal injuries that heal with scar tissue formation, often achieving reduced biomechanical and functional properties. The murine patellar tendon is a research tool that holds potential for investigating tendon healing and can be useful for exploring therapeutic strategies. Since healing is a complex process that results from the collaboration between the systemic and local tissue environment, a murine tendon transplantation model that can be applied to transgenic mice and genetic mutants would allow isolation of systemic versus local tendon factors in driving effective tendon healing. Read More

Mil Med Res 2019 11 19;6(1):35. Epub 2019 Nov 19.

Plastic and Reconstructive Aesthetic Surgery, Hatay Defne State Hospital, 31000, Antakya, Hatay, Turkey.

Background: The radial nerve is one of the most common war-related injury sites due to penetrating cutting tool injuries or gunshot wounds, resulting in drop-hand syndrome. The aim of this study was to evaluate the outcomes of tendon transfer in patients with drop-hand syndrome who had been injured in the Syrian Civil War.

Methods: This level-II, prospective, comparative study included 13 civilians injured in the Syrian Civil War 2015 and 2017. Read More

Ann Plast Surg 2020 03;84(3):283-287

Department of Plastic and Reconstructive Surgery, School of Medicine, Shinshu University, Nagano, Japan.

Background: Postoperative scar adhesions between tendons and phalanx bones cause persistent disability in complex injuries involving tendons and bones of the hand. Although gliding tissue reconstruction is effective in preventing peritendinous adhesion formation and a dorsal digital adipofascial flap is a reliable method to prevent scar adhesion between tendon and bone after extensor tendon repair, no comparative clinical reports exist. This study aimed to determine the usefulness of a gliding tissue reconstruction method by comparing postoperative range of motion between patients who underwent gliding tissue reconstruction and those who did not. Read More

Artif Organs 2020 Apr 14;44(4):E161-E171. Epub 2019 Nov 14.

Unit of Regenerative Therapy, Service of Plastic, Reconstructive and Hand Surgery, Department of Musculoskeletal Medicine, Lausanne University Hospital, Lausanne, Switzerland.

Chronic and acute tendon injuries are frequent afflictions, for which treatment is often long and unsatisfactory. When facing extended injuries, matrices and scaffolds with sufficient biomechanical properties are required for surgical repair and could additionally serve as supports for cellular therapies to improve healing. In this study, protocols of either commonly used detergents only (SDS 1%, Triton 1%, TBP 1%, and Tween-20 1%) or a combination of freeze/thaw (F/T) cycles with decellularization agents (NaCl 1M, ddH O) were evaluated for the decellularization of horse equine superficial digital flexor tendon (SDFT) for hand flexor or extensor tendon reconstruction. Read More

Microsurgery 2020 Mar 12;40(3):391-394. Epub 2019 Oct 12.

C.O.O., Azienda Socio Sanitaria Territoriale Gaetano Pini, Milan, Italy.

Reconstruction of foot structures is challenging because of the need to restore both anatomy and function. Extensor hallucis longus (EHL) excision without reconstruction could result in a flexion deformity of the toe at the interphalangeal joint. In this report, we present a case of the use of a palmaris longus tendon included in a fasciocutaneous radial forearm free flap to reconstruct EHL tendon and soft tissues of the distal foot dorsum. Read More

J Anat 2020 Jan 30;236(1):165-170. Epub 2019 Sep 30.

VetCore Facility for Research, Vetmeduni Vienna, Vienna, Austria.

Cells use different cell adhesion and communication structures to promote tissue development, maintenance of tissue integrity as well as repair and regenerative processes. Another recently discovered way of information exchange is long-distance thin cellular processes called nanotubes (NTs), mainly studied in vitro. Information on the existence and relevance of NTs in vivo is sparse. Read More

J Foot Ankle Surg 2019 Nov 25;58(6):1276-1280. Epub 2019 Sep 25.

Surgeon, Department of Trauma, Hand, Plastic and Reconstructive Surgery, University Hospital Wuerzburg, Wuerzburg, Germany.

There are different treatment options for extensor hallucis longus injuries. For primary repair, the end-to-end suture is recommended. The treatment of reruptures or tendon defects is challenging, and a wide range of procedures have been used in this regard, including primary and secondary repairs with and without auto- and allografts. Read More

J Ayub Med Coll Abbottabad 2019 Jul-Sep;31(3):320-325

Sharif Medical and Dental College, Lahore, Pakistan.

Background: The long-disputed issue of rehabilitation of extensor tendon repairs in zones V-VII has been treated with either complete immobilization or mobilization within the constraints of splint. In recent times, most authors have preferred some mobilization. Many studies have shown good results with early mobilization techniques; however, these studies have limitations. Read More

Tech Hand Up Extrem Surg 2020 Mar;24(1):20-25

Christine M Kleinert Institute for Hand and Microsurgery, Louisville, KY.

Sagittal band injuries may result in extensor digitorum communis (EDC) tendon instability and may require operative treatment for symptomatic loss of extension, pain, and snapping at the metacarpophalangeal joint (MCPJ). Operative methods vary according to the source of donor tissue, as well as the anchor point of attachment. We present a surgical technique that diminishes tension of the repair with MCPJ flexion. Read More

Arthrosc Tech 2019 Jul 17;8(7):e775-e779. Epub 2019 Jul 17.

Tulane Institute of Sports Medicine, Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, U.S.A.

Lateral epicondylitis, or tennis elbow, involves degeneration of the extensor carpi radialis brevis tendon and is often self-limiting, with surgery reserved for recalcitrant cases. Surgical management of tennis elbow consists primarily of either debridement alone or debridement with repair. Surgical repair is often performed using either a suture or a suture anchor. Read More

Arthrosc Tech 2019 Jul 10;8(7):e705-e712. Epub 2019 Jun 10.

Department of Orthopaedic Surgery, Tufts Medical Center, Boston, Massachusetts, U.S.A.

Although triceps tendon tears are less common than other tendon tears, complete ruptures require surgical repair to restore the strength of the extensor mechanism of the elbow. There are several described techniques for repair using both transosseous tunnels and suture anchors. Current techniques often result in large suture knots over the dorsal ulna under thin subcutaneous tissue, which can be irritating for patients. Read More

Int J Surg Case Rep 2019 20;62:73-76. Epub 2019 Aug 20.

Department of Orthopaedic Surgery, Wan Fang Hospital, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address:

Background: Snapping fingers resulting from flexor tendon tenosynovitis at the metacarpophalangeal (MCP) joint, is common. However lateral band snapping syndrome (LPSS) in the proximal interphalangeal joint (PIPJ) are extremely rare.

Case Presentation: A 43-year-old female was diagnosed with LPSS in the PIPJ of fifth finger which was confirmed by dynamic evaluation upon ultrasound. Read More

J Am Podiatr Med Assoc 2019 May;109(3):246-252

Hallux varus is most commonly seen iatrogenically following overaggressive lateral release, removal of the fibular sesamoid, or overaggressive removal of the medial eminence. There are several reported cases of traumatic hallux varus, although this is much less common. We present a case of traumatic hallux varus in a patient who was later found to have bilateral absence of her fibular sesamoids. Read More

FP Essent 2019 Jul;482:23-26

Uniformed Services University Department of Family Medicine, 4301 Jones Bridge Road A1038, Bethesda, MD 20814-4799.

Family physicians commonly treat athletes with simple fractures and other musculoskeletal injuries that require temporary immobilization. Certain fractures (eg, intraarticular, multiple, open, associated with dislocations or tendon injury) typically are managed by orthopedic subspecialists. During the healing process, a custom-molded or prefabricated orthopedic support, known as an orthosis, may be used to support the injured area and prevent reinjury. Read More

J Hand Surg Eur Vol 2019 Sep 24;44(7):667-675. Epub 2019 Jun 24.

1 Department of Plastic Surgery, Vascularized Composite Allotransplantation Center, Chang Gung Memorial Hospital.

Vascularized toe joint transfers to the fingers have been performed for more than four decades, but their outcomes are not comparable with implant arthroplasty. Limited range of motion and extensor deficits of about 30° remain major problems with the constructed joints. We observed that the central extensor tendon of the toe is often attenuated proximally in its course on the dorsum of the proximal interphalangeal joint. Read More

J Bone Joint Surg Am 2019 Jun;101(11):1010-1015

Department of Orthopedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.

Background: Quadriceps tendon rupture following total knee arthroplasty (TKA) is an infrequent but potentially devastating adverse event. Although uncommon, the long-term sequelae of this injury can result in permanent inability to walk. Despite the severity of this injury, there is no single accepted treatment, with various surgical methods producing mixed results. Read More

Clin Plast Surg 2019 Jul 16;46(3):383-391. Epub 2019 Apr 16.

Section of Plastic Surgery, Department of Surgery, Michigan Medicine Comprehensive Hand Center, Michigan Medicine, University of Michigan, 2130 Taubman Center, SPC 5340, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5340, USA. Electronic address:

Thin soft tissue covering extensor tendons make them prone to injury. The extensor mechanism achieves a delicate balance with the flexor system. Inappropriate management in the acute setting can lead to long-term deformity and dysfunction. Read More

JBJS Essent Surg Tech 2019 Mar 27;9(1):e8. Epub 2019 Feb 27.

Wrightington Hospital, Wigan, United Kingdom.

The elbow is the second most common site for joint dislocation after the shoulder. Elbow dislocations are classified according to the direction of dislocation, with most (80%) being posterolateral. A spectrum of soft-tissue injury may also be present, depending on the direction of dislocation and the energy applied. Read More

J Hand Ther 2019 May 9. Epub 2019 May 9.

BBJP Orthopedics, Bellevue, WA, USA.

Study Design: Case report.

Introduction: Zone III extensor tendon injuries are typically treated with early mobilization or by a period of immobilization followed by gradual motion. In both scenarios, the use of multiple orthoses is required. Read More

J Knee Surg 2019 May 8. Epub 2019 May 8.

Department of Orthopaedics, University of Rochester, Rochester, New York.

Simultaneous bilateral extensor mechanism disruption (BEMD) is a rare condition, for which the relationship between comorbid conditions, complications, and clinical outcomes has not been well defined. We hypothesized that patients with BEMD would have more comorbidities, more repair failures, and worse clinical outcomes compared with patients with unilateral extensor mechanism disruption (UEMD). We performed a retrospective review of all adult patients seen at our institution for either a quadriceps or patellar tendon rupture between 2012 and 2017. Read More

Oper Orthop Traumatol 2020 Feb 7;32(1):82-86. Epub 2019 May 7.

Unfall‑, Hand- und Ellenbogenchirurgie, Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum zu Köln, Köln, Deutschland.

The Problem: Stable pronator quadratus repair following volar plate fixation of distal radius fractures with complete plate coverage is often difficult.

The Solution: Detachment of the pronator quadratus muscle (PQ) with a strong rim of connective tissue consisting of a fibrous portion of the roof of the first extensor compartment and the volar limb of the brachioradialis muscle (BR) insertion; stable suture repair of the PQ with complete coverage of a volar plate after osteosynthesis of a distal radius fracture.

Surgical Technique: Radiopalmar approach between the radial artery and the flexor carpi radialis tendon to the PQ; sharp dissection below the radial artery onto the first extensor compartment, which is opened; retraction of the extensor pollicis brevis and abductor pollicis longus tendon; presentation of the BR insertion at the bottom of the first extensor compartment; incision of the BR insertion halfway to proximal and dissection of the volar limb at the transition to the free BR tendon; release of the PQ from the distal radius; after reduction and internal fixation repair of the PQ with complete coverage of the volar locking plate due to slight distal transposition. Read More