Objective: This retrospective study was designed to evaluate the outcomes of four different surgical reconstructions for extensor tendon ruptures in ulnar three fingers in 48 patients with rheumatoid arthritis.
Methods: The following four techniques were performed; palmaris longus tendon grafting (PL group; n = 9), extensor indicis proprius (EIP) tendon transfers (EIP group; n = 8), end-to-side transfers with tension-reduced early mobilization (End-to-side group; n = 16), and a combination of end-to-side and EIP transfers (Combination group; n = 15). Loss of extension was evaluated to determine the mean postoperative range of motion of the metacarpophalangeal (MP) joint and clinical outcomes were categorized using modified Geldmacher criteria.
Results: Combination group demonstrated the best mean MP joint extension (-3°), followed by End-to-side group (-12°), EIP group (-16°), and PL group (-21°). Combination group yielded the best clinical outcomes with all cases showing good results.
Conclusions: The combination of end-to-side and EIP transfer was an effective surgical reconstruction procedure for triple fingers extension loss.
Keywords: Rheumatoid arthritis; Tendon reconstruction; Tension-reduced early mobilization; Triple fingers extension loss.