Division of Hand Surgery and Microsurgery - Modena University Hospital.
Division of Plastic Surgery, Modena University Hospital.
Acta Biomed. 2021 Apr 30;92(S1):e2021151. doi: 10.23750/abm.v92iS1.9756.
The authors discuss challenges in extensor function restoration at the finger level following distal posterior interosseous or tendon complex injuries, according to the typologies of lesions or the specific patient requirements.
The authors report on two cases describing challenging resolutions. One patient with EDC lag from zone 6B to 8 requiring FCU prolonged with cadaveric grafts. One young patient with distal posterior interosseous lesion requiring selective tendon transfers to EPL and EIP to restore selective and autonomous index extension.
In both cases the main goals were obtained, achieving high index of patient satisfaction and excellent outcomes with the restoration of the extension of the fingers. Conclusions: In distal posterior interosseous nerve lesion, high demanding patients may require selective function to restore fine motor skills, such as autonomous index extension. In extensor tendons loss of substance from zone 6 to 8, involving musculotendinous junction proximally and short remnants distally, by-pass tendon transfer prolonged with cadaveric grafts is required. The authors highlight the techniques available as escape plan according to the necessary solutions.
作者根据损伤类型或特定患者需求，讨论了远端后骨间或肌腱复合体损伤后手指伸肌功能恢复的挑战。
作者报告了两例具有挑战性的解决方案。一名 EDC 滞后的患者（6B 区至 8 区）需要 FCU 通过尸体移植物延长。一名年轻的患者患有远端后骨间病变，需要选择性的肌腱转移到 EPL 和 EIP 以恢复选择性和自主的食指伸展。
在这两种情况下，主要目标都实现了，患者满意度高，手指伸展恢复效果良好。结论：在远端后骨间神经病变中，高要求的患者可能需要选择性功能来恢复精细运动技能，如自主食指伸展。在伸肌腱从 6 区到 8 区的实质性损失中，近端涉及肌肉肌腱结合部，远端残留短，需要通过尸体移植物延长的旁路肌腱转移。作者强调了根据需要的解决方案作为备用方案的可用技术。
