Dr. Cole, a seasoned orthopaedic professional, and Dr. Woolwine, an expert in tendon issues, dive deep into hand tendon injuries and their treatment. They examine flexor and extensor tendon injuries, detailing repair techniques and the significance of timely intervention. Insight into tendon healing complexities and potential post-surgery complications like adhesions is also discussed. The pair emphasizes the critical role of proper surgical techniques, tension management, and rehabilitation strategies for effective recovery.
Understanding the anatomical zones of flexor and extensor tendon injuries is crucial for tailoring appropriate treatment strategies and ensuring successful outcomes.
Postoperative complications, such as adhesions and ruptures, require meticulous surgical techniques and rehabilitation practices to restore function in tendon repairs.
Deep dives
Understanding Flexor Tendon Injuries
Flexor tendon injuries are categorized by specific anatomical zones, each requiring tailored treatment strategies. Zone one includes injuries like FDP avulsions, where early repair is critical to prevent complications. Zones two and three, often referred to as 'no man's land', pose greater risks for adhesions, leading to less favorable outcomes and necessitating a more careful approach in repair. Knowledge of these zones is essential for orthopedic residents, as repair techniques vary significantly based on the injury's location and severity.
Extensor Tendon Considerations
Extensor tendon injuries often respond favorably to non-operative treatments compared to flexor tendon injuries, which tend to rely more heavily on surgical intervention. Various zones characterize extensor tendon injuries, such as zones one and two, which can lead to mallet finger if treatment is not appropriately administered. The management of these injuries may include specialized splinting techniques and surgical interventions in cases of complications like boutonniere deformities. The simpler anatomy and less complex pulley systems of extensor tendons allow for more straightforward repair and rehabilitation.
Complications and Reconstruction Strategies
Complications following tendon repairs include adhesions, ruptures, and joint contractures, which highlight the importance of proper surgical techniques and postoperative care. Conditions such as the quadriga effect can arise when a repaired tendon becomes tighter than surrounding tendons, affecting overall finger mobility. Treatment strategies for these complications may involve surgical releases or specialized rehabilitation practices to restore function. Learning to manage these complications and the indications for reconstructive procedures is vital knowledge for orthopedic residents preparing for advanced exams.
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Enjoy another episode from our board review series featuring Dr. Cole and Dr. Woolwine.
This episode is sponsored by the American Academy of Orthopaedic Surgeons:
Filled with content that has been vetted by some of the top names in orthopaedics, the AAOS Resident Orthopaedic Core Knowledge (ROCK) program sets the standard for orthopaedic education.
Whether ROCK is incorporated into your residency curriculum, or you use it independently as a study tool, the educational content on ROCK is always free to residents. You’ll gain the insights and confidence needed to ensure a successful future as a board-certified surgeon who delivers the best patient care. Log on at https://rock.aaos.org/.
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