gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Study of independent extension of little finger after reconstruction of extensor tendon rupture of ring and little fingers in rheumatoid arthritis

Meeting Abstract

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  • presenting/speaker Tetsuo Masuda - Hiroshima Prefectural Rehabilitation Center, Higashi Hiroshima, Japan
  • Takaya Mizuseki - Hiroshima Prefectural Rehabilitation Center, Higashi Hiroshima, Japan
  • Osami Suzuki - Hiroshima Prefectural Rehabilitation Center, Higashi Hiroshima, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-1273

doi: 10.3205/19ifssh0741, urn:nbn:de:0183-19ifssh07417

Veröffentlicht: 6. Februar 2020

© 2020 Masuda et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: The extensor tendon subcutaneous rupture caused by rheumatoid arthritis (RA) is the most commonly observed in the ring and little finger, and we frequently use the extensor indicis proprius (EIP) transfer in its reconstruction. According to the method, the independence movement of the ring and little finger is theoretically impossible. On the other hand, as the number of RA patients returning to society increases, it is expected that more patients need to develop independent fingers such as typing and piano performances.?This may make piano playing or typing difficult. In this study, we followed up the cases of surgical reconstruction for subcutaneous extensor rupture of the ring and little fingers and examined the independent function of the little finger.

Methods: Since 1992, there were 32 patients who received reconstructive surgery for extensor tendon ruptures of the ring and little finger. 32 cases were reconstructed with EIP transfer and 6 were reconstructed with end-to-side suture (suture to middle EDC) were targeted. The postoperative function was evaluated by the range of motion of the little finger MP joint, EDM test, the presence / absence of troubles in daily life activity, and deterioration of functions due to exacerbation of RA.

Results and Conclusions: Three cases developed joint deformity due to exacerbation of RA, and two cases developed re-rupture. In the other cases, the averaged the range of motion of the little finger MP joint improved from -48 degrees to -8.8 degrees in the EIP transfer group, while in the end-to-side suture group from -42 degrees to -6.4 degrees. In postoperative EDM test, 20 cases were negative and 12 cases were positive in EIP transition group, 3 cases were negative and 3 cases were positive in end-to-side suture group. As for the troubles in daily life activity, one case (3.1%) in the EIP group and two cases (33.3%) in the end-to-side suture group answered that there was a problem; all of them had positive postoperative EDM test.

Although independent extension disturbance of the little finger was anticipated after grouped reconstruction of the ring and little fingers, only limited patients exhibited impairment of independent little finger extension and very few patients complained of ADL disturbance.