Orthopedic & Muscular System: Current Research

Orthopedic & Muscular System: Current Research
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ISSN: 2161-0533

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Image Article - (2017) Volume 6, Issue 2

Extensor Tendon Injury in the Distal Forearm of Right Hand Owing to Accident

Md. Sahab Uddin1*, Abdullah Al Mamun1, Md. Tanvir Kabir2, Md. Manjurul Islam3, Md. Waliullah Wali1, Md. Ziaul Islam1 and Ripa Moutoshi4
1Department of Pharmacy, Southeast University, Dhaka, Bangladesh
2Department of Pharmacy, BRAC University, Dhaka, Bangladesh
3Department of Pharmacy, University of Development Alternative, Dhaka, Bangladesh
4Department of Pharmacy, State University of Bangladesh, Dhaka, Bangladesh
*Corresponding Author: Md. Sahab Uddin, Department of Pharmacy, Southeast University, Dhaka, Bangladesh, Tel: +880 1710220110, 1670760546 Email: ,

Abstract

A Bangladeshi 24 year old man was admitted to the hospital with a right hand injury. The examination showed that the tendons of the right hand of the patient were severely injured. X-ray report showed no bone injury. Within 24 h of the accident surgery was performed but the patient was unable to move the thumb. Therefore a second time surgery was performed. In the second surgery extensor carpi radialis longus (ECRL), extensor carpi radialis brevis (ECRB), abductor pollicis brevis (APB), extensor pollicis brevis (EPB) were found defected and all separated tendons were repaired effectively.

Keywords: Extensor tendon; Injury; Distal forearm; Right hand

Abbreviations

EPL: Extensor pollicis longus; ECRL: Extensor carpi radialis longus; ECRB: Extensor carpi radialis brevis; APB: Abductor pollicis brevis; EPB: Extensor pollicis brevis

Image Description

The extensor tendons are situated in a superficial site on the dorsal aspect of the hand [1,2]. They lie just under the skin (i.e., back of the hands and fingers) and are highly prone to injury by a minor cut that may cause the tendons to split from their addition to the bone [3,4]. The extensor tendon injury has the potential to seriously impair hand function [5,6]. Repair of extensor tendon injury can be challenging and treatments differ depending on the place of the defect [7,8].

A 24 year old Bangladeshi man with a right hand injury was admitted to the hospital as a result of an accident by a ceiling fan. Figure 1 represents the injured right hand of the patient immediately after the accident. The X-ray report of the right hand reported no serious injury in the bone (Figure 2). The physician examined that extensor tendons of the right hand were damaged and within 24 h of the accident surgery was performed. The condition of the right hand after 30 days of the surgery is given in Figure 3. But it is a matter of regret that the patient was unable to move the thumb of the right hand. Thus physicians recommended second time surgery and their examination revealed the following points:

Equation

Figure 1: The right hand of the patient after injury.

Equation

Figure 2: X-ray of the right hand of the patient.

Equation

Figure 3: The right hand of the patient after first surgery.

• Extensor pollicis longus (EPL) was found intact

• Extensor carpi radialis longus (ECRL) was found partially injured

• Extensor carpi radialis brevis (ECRB) was found partially injured

• Abductor pollicis brevis (APB) was found found injured

• Extensor pollicis brevis (EPB) was found found injured

The surgery successfully repaired all defected tendons. In the Figure 4, the condition of the right hand after 15 days of the second surgery was represented. Now the patient can move the thumb, but he has lost about 50% of his writing speed and felt discomfort to perform daily activities. In Figure 5, X-ray images and in Figure 6 the current conditions of the right hand are presented.

Equation

Figure 4: The right hand of the patient after second surgery.

Equation

Figure 5: The present condition of the X-ray of the right hand of the patient.

Equation

Figure 6: The present condition of the right hand of the patient.

Consent of the Patient

The authors took consent from the patient.

Consent for Publication

The authors took consent from the patient for publication.

Authors’ Contributions

This work was carried out in collaboration between all authors. Authors MSU, AAM, MTK, MMI, MWW, MZI and RM participated to collect images and prepared the draft of the manuscript. All the authors read and approved the final manuscript.

Acknowledgements

The authors wish to thank the anonymous reviewer(s)/editor(s) of this article for their constructive reviews.

Competing Interests

The authors proclaim that they have no competing interests.

References

  1. Waugh A, Grant A (2010) Ross & Wilson anatomy and physiology in health and illness. Elsevier Health Sciences.
  2. Matzon JL, Bozentka DJ (2010) Extensor tendon injuries. J Hand Surg 35(5): 854-861.
  3. Drake R, Vogl AW, Mitchell AW (2009) Gray's anatomy for students. Elsevier Health Sciences.
  4. Kochevar A, Rayan G, Angel M (2009) Extensor tendon reconstruction for zones II and IV using local tendon flap: A cadaver study. J Hand Surg Am 34(7): 1269-1275.
  5. Stewart G, Cooley DA (2009) The skeletal and muscular systems. Infobase Publishing, New York.
  6. Elliott RA (1970) Injuries to the extensor mechanism of the hand. Orthop Clin North Am 1(2): 335-354.
  7. Kleinert HE, Verdan C (1983) Report of the committee on tendon injuries. J Hand Surg Am 8: 794-798.
  8. Türker T, Hassan K, Capdarest-Arest N (2016) Extensor tendon gap reconstruction: A review. J Plastic Sur Hand Sur 50(1): 1-6.
Citation: Uddin MS, Mamun AA, Kabir MT, Islam MM, Wali MW, et al. (2017) Extensor Tendon Injury in the Distal Forearm of Right Hand Owing to Accident. Orthop Muscular Syst 6: 235.

Copyright: © 2017 Uddin MS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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