ANALYSIS OF UNSATISFACTORY RESULTS IN TREATMENT OF CLOSED INJURIES OF EXTENSOR TENDONS OF FINGERS OF A HAND IN THE I-ST ZONE

In the international society of hand surgery, it is commonly accepted to use immobilization of distal interphalangeal joint in the hyperextension position at closed and open injuries of extensor tendons in the I-st zone. According to clinical anatomy data, hand extensor tendons are in reciprocal relation with deep digital flexors, that is, at flexion of finger joints, lateral extension tendon fascicles relax. This fact is fully ignored by the medical society. Goal of the study. The goal was to carry out the thorough study of the influence of flexion and extension in joints of an injured finger, as well as contraction of small muscles of hand on the duration of diastasis of the ends of injured extension tendon in the I-st zone. Material and methods. In the period from 2013 till 2016, 174 patients with recent and old injuries of extension tendons of fingers in the I-st zone were surveyed. The age of the patients was from 16 to 74 years. The group included 98 men and 76 women (average age of 42 ± 12). 145 patients with recent and old injuries (Tomsk and Tomsk Oblast) applied to the hospital of the Scientific Research Institute of Microsurgery for planned and emergency treatment; 29 patients applied to our hospital with unsatisfactory results of conservative and surgical treatment in other Tomsk and foreign clinics. All the patients received surgical treatment within the framework of “new” paradigm implemented in our hospital since 2014. Four patients were examined for the values of diastasis between the ends of the injured extension tendon in the I-st zone (ultrasound, MRT, EMG of palmar interosseous muscles and lumbrical muscles).

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