Clinical Results of Autogenous Palmaris Longus Tendon Graft for Ruptures of Multiple Extensors in Rheumatoid Hands

Abstract

PURPOSE: The purpose of this study was to evaluate the clinical outcome of autogenous palmaris longus grafting for extensor tendon ruptures of 2 or more fingers in rheumatoid hands and to identify the factors related to the clinical outcome. METHODS: Between 2000 and 2013, a total 41 patients with advanced rheumatoid arthritis and multiple extensor tendon ruptures reconstructed with autogenous palmaris longus tendon grafts were reviewed. Extension lag at the metacarpophalangeal (MCP) joint, total active motion (TAM), and fingertip-to-palm (TTP) distance were evaluated at final follow-up. Simple regression analysis was done to determine the factors predictive of clinical outcome. RESULTS: The mean extension lag at the MCP joint of the reconstructed finger was 9 degrees (range, 0 degrees -90 degrees : median, 0 degrees ). The mean TAM was 239 degrees (range, 85 degrees -280 degrees : median, 260 degrees ), and the mean TTP distance was 5 mm (range, 0-50 mm: median, 0 mm). Simple regression analysis showed that only age was related to extension lag at the MCP joint and only arthritis of the MCP joint was related to TAM. CONCLUSIONS: In rheumatoid arthritis, extensor tendon reconstruction of multiple extensor tendon ruptures using autogenous palmaris longus tendon graft is a viable option to achieve a favorable clinical result. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.