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Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports
BACKGROUND: While some traumatic closed index extensor tendon ruptures at the musclotendinous junction have been previously reported, closed index extensor tendon pseudorupture due to intertendinous attenuation is exceedingly rare with only one case report of a gymnastics-related sports injury in th...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547513/ https://www.ncbi.nlm.nih.gov/pubmed/33038920 http://dx.doi.org/10.1186/s12891-020-03692-6 |
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author | Miyashima, Yusuke Uemura, Takuya Yokoi, Takuya Hama, Shunpei Okada, Mitsuhiro Konishi, Sadahiko Nakamura, Hiroaki |
author_facet | Miyashima, Yusuke Uemura, Takuya Yokoi, Takuya Hama, Shunpei Okada, Mitsuhiro Konishi, Sadahiko Nakamura, Hiroaki |
author_sort | Miyashima, Yusuke |
collection | PubMed |
description | BACKGROUND: While some traumatic closed index extensor tendon ruptures at the musclotendinous junction have been previously reported, closed index extensor tendon pseudorupture due to intertendinous attenuation is exceedingly rare with only one case report of a gymnastics-related sports injury in the English literature. Herein, we report two non-sports injury related cases of traumatic index extensor tendon attenuation mimicking closed tendon rupture, including the pathological findings and intraoperative video of the attenuated extensor indicis proprius tendon. CASE PRESENTATION: A 28-year-old man and a 30-year-old man caught their hands in a high-speed drill and lathe, respectively, which caused a sudden forced flexion of their wrists. They could not actively extend the metacarpophalangeal joints of their index fingers. Intraoperatively, although the extensor indicis proprius and index extensor digitorum communes tendons were in continuity without ruptures, both tendons were attenuated and stretched. The attenuated index extensor tendons were reconstructed either with shortening by plication or step-cut when the tendon damage was less severe or, in severely attenuated tendons, with tendon grafting (ipsilateral palmaris longus) or tendon transfer. Six months after the operation, the active extension of the index metacarpophalangeal joints had recovered well. CONCLUSIONS: Two cases of traumatic index extensor tendon attenuation were treated successfully by shortening the attenuated tendon in combination with tendon graft or transfer. We recommend WALANT (wide-awake local anesthesia and no tourniquet) in the reconstruction surgery of index extensor tendon attenuation to determine the appropriate amount of tendon shortening or optimal tension for tendon grafting or transfer. Intraoperative voluntary finger movement is essential, as it is otherwise difficult to judge the stretch length of intratendinous elongation and extent of traumatic intramuscular damage affecting tendon excursion. |
format | Online Article Text |
id | pubmed-7547513 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-75475132020-10-13 Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports Miyashima, Yusuke Uemura, Takuya Yokoi, Takuya Hama, Shunpei Okada, Mitsuhiro Konishi, Sadahiko Nakamura, Hiroaki BMC Musculoskelet Disord Case Report BACKGROUND: While some traumatic closed index extensor tendon ruptures at the musclotendinous junction have been previously reported, closed index extensor tendon pseudorupture due to intertendinous attenuation is exceedingly rare with only one case report of a gymnastics-related sports injury in the English literature. Herein, we report two non-sports injury related cases of traumatic index extensor tendon attenuation mimicking closed tendon rupture, including the pathological findings and intraoperative video of the attenuated extensor indicis proprius tendon. CASE PRESENTATION: A 28-year-old man and a 30-year-old man caught their hands in a high-speed drill and lathe, respectively, which caused a sudden forced flexion of their wrists. They could not actively extend the metacarpophalangeal joints of their index fingers. Intraoperatively, although the extensor indicis proprius and index extensor digitorum communes tendons were in continuity without ruptures, both tendons were attenuated and stretched. The attenuated index extensor tendons were reconstructed either with shortening by plication or step-cut when the tendon damage was less severe or, in severely attenuated tendons, with tendon grafting (ipsilateral palmaris longus) or tendon transfer. Six months after the operation, the active extension of the index metacarpophalangeal joints had recovered well. CONCLUSIONS: Two cases of traumatic index extensor tendon attenuation were treated successfully by shortening the attenuated tendon in combination with tendon graft or transfer. We recommend WALANT (wide-awake local anesthesia and no tourniquet) in the reconstruction surgery of index extensor tendon attenuation to determine the appropriate amount of tendon shortening or optimal tension for tendon grafting or transfer. Intraoperative voluntary finger movement is essential, as it is otherwise difficult to judge the stretch length of intratendinous elongation and extent of traumatic intramuscular damage affecting tendon excursion. BioMed Central 2020-10-10 /pmc/articles/PMC7547513/ /pubmed/33038920 http://dx.doi.org/10.1186/s12891-020-03692-6 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Case Report Miyashima, Yusuke Uemura, Takuya Yokoi, Takuya Hama, Shunpei Okada, Mitsuhiro Konishi, Sadahiko Nakamura, Hiroaki Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
title | Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
title_full | Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
title_fullStr | Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
title_full_unstemmed | Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
title_short | Traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
title_sort | traumatic index extensor tendon attenuation mimicking closed tendon rupture: two case reports |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7547513/ https://www.ncbi.nlm.nih.gov/pubmed/33038920 http://dx.doi.org/10.1186/s12891-020-03692-6 |
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