抄録
The results of surgical treatment for extensor tendon rupture in rheumatoid patients are reported. Forty cases (3 males and 37 females) were followed up for an average of 9 years and 10 months (from 6 months to 16 years) . Ages ranged from 30 to 78 years with an average of 54.9, and the duration of the disease was from 2.5 to 38 years, 9.8 on an average. Surgical treatment was done in 32 right hands and 8 left hands. The tendon ruptures were located in the thumb (4), and in the middle (9), ring (27) and little fingers (33) . Surgical procedures included tendon transfer in 25, end-to-end suture in 8, and bridge tendon graft in 7 hands. Synovectomy of the wrist joint and resection of the distal ulna were performed in all cases. The wrist, MP, and PIP joints were fixed in extended position in a plaster cast for a week and active flexion exercise was encouraged with a modified Swanson's splint for 4 to 5 weeks.
The results were assessed by the ROM of the MP joints, the ADL of the operated-on hands and the radiographic changes. Most patients were satisfied with the postoperative results of MP ROM and ADL except those with end-to-end suture, in which marked limitation of the flexion in the MP joint took place. The ROM of the MP joints tended to decrease in parallel with the progression of the disease. Tendon transfer of rheumatoid hand combined with synovectomy and resection of the distal ulna end gives satisfactory results in the treat-ment of ruptured extensor tendons.
