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Theme: Inclusion and Collaboration Theme: Inclusion and Collaboration

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THE FUNCTION AND THE STRENGTH OF THE THUMB IS NOT AFFECTED WHEN THE EXTENSOR POLLICIS LONGUS TENDON IS LEFT OUT OF EXTENSOR RETINACULUM
Fatih Kabakas, MD; Hand and Microsurgery, IST-EL Hand Surgery, Microsurgery and Rehabilitation Group, Istanbul, Turkey; Meriç U?urlar, MD; Sisli Hamidiye Etfal Training and Research Hospital, ?stanbul, Turkey; Bari? Çaypinar, MD; Lütfiye Nuri Burat Public Hospital, Istanbul, Turkey; Abdulkadir Sar?, MD; Nam?k Kemal University School of Medicine, Tekirda?, Turkey; Berkan Mersa, Ass. Prof.; IST-EL Hand Surgery, Microsurgery and Rehabilitation Group, Istanbul, Turkey; ?smail Bülent Özçelik, Ass. Prof.; IST-EL Hand Surgery, Microsurgery and Rehabilitation Group, ?stanbul, Turkey

Hypothesis:

Leaving extensor pollicis longus (EPL) tendon out of retinaculum in cases performed through a dorsal approach at the level of extensor retinaculum after opening the 3rd extensor compartment reduces risk of adhesion and rupture which may occur.

The aim of our study is to try to understand whether leaving EPL in the subcutaneous tissue that is released from extensor compartment during any surgery, without reconstructing the third extensor compartment causes any change on extension strength and range of motion (ROM) of the interphalangeal (IP) and metacarpophalangeal (MCP) joints of the thumb or not.

Methods:

Twenty patients operated between 1995 and 2013 were evaluated retrospectively. EPL tendons of all patients were left out of extensor retinaculum after opening 3rd extensor compartment through dorsal approach to wrist. The following surgeries were performed: wrist arthrodesis in 4 patients, vascularized bone flaps from the 4th ECA (extensor compartmental artery) for Kienböck's disease in 2 patients, open reduction after perilunate fracture-dislocations in 2 patients, proximal row carpectomy after Kienböck's disease in 2 patients, distal radius fracture surgery through dorsal approach in 6 patients.

Extension strength (in kg) and voluntary ROM (in degree) of the MCP and IP joints of the thumb were measured. Opposite extremity values were measured and compared statistically.

Results:

No statistically significant reduction was determined in strength and ROM of IP and MCP joints of the thumb in the operated side of patients whose EPLs were left out of retinaculum compared with the nonoperated side.

Summary points:

We determined that leaving EPL tendon out of retinaculum in such cases with increased risk of adhesions and rupture, did not cause a marked muscle weakness and loss of range of movement.

Level of evidence III.


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