4/9/2023 0 Comments Extensor tendon compartmentsThis is a retrospective chart review of four patients who presented to our institution between Jand Jwith injuries to Zones VIII and XI. We provide a surgical technique for treating these patients. The purpose of this study is to highlight that extensor tendon injuries in Zones VIII and IX are challenging due to the proximity of the musculotendinous junction, and injury to the posterior interosseous nerve (PIN). The machete injury is similar to the “nightstick” fracture injury as it is natural reflex is to protect one’s face/head with one’s forearm during an attack. We have recently treated four of these injuries: three due to assault with a machete and one due to a fall on broken glass. This assumption may also explain the paucity in the literature on the long-term outcomes following extensor tendon repair, and on how to manage extensor tendon injuries especially in Zones VIII and IX (as classified by Verdan). Additionally, it may be due to the superficial location of these tendons making them more accessible than flexor tendons. This may be due to the fact that extension in the hand is not essential to normal function and small losses in extension are easily compensated due to redundancy built into the extensor tendon system. There is a prevailing assumption that extensor tendon injuries are not difficult to manage because they all have good outcomes. We present four patients with injuries to Zones VIII and IX as well as a review of surgical technique, postoperative rehabilitation, and pearls that may be of benefit to those managing these injuries. A review of the literature shows little guidance and attention for these injuries. When lacerations occur in the forearm as in Zones VIII and IX injury, the repair of the extensor tendon and muscle, and posterior interosseous nerve (PIN) is often challenging. However, these injuries can be complex and demand a thorough understanding of anatomy to achieve the best functional outcomes. Extensor tendon injuries are widely believed to be straightforward problems that are relatively simple to manage.
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