A 2-free-end flexor carpi radialis tendon graft for treating a complex index finger extensor tendon injury

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Giovanni Battista Colasanti
Carlotta Pari
Agnese Puzzo
Stefania Paderni
Claudio Goretti
Alberto Belluati


KEYWORDS: Distal Radius Volar Plating, Extensor Tendon Injuries, FCR tendon Graft


Background: Volar plating has increasingly become the most used technique for the treatment
of unstable distal radius fractures due to the low soft-tissue disturbance and its biomechanical reliability,
which allows the early mobilization of the wrist. One of the main goals of the volar locking compression
plates design is to avoid those soft tissue complications historically associated to the dorsal plating. However,
extensor tendon complications can not be completely excluded. Method: The authors report the case of a
patient with a complete rupture of the index finger extensor tendons after volar plate fixation of the distal
radius. Due to the presence of a severe tendons retraction with a 4-centimeter gap and the neighbouring
soft tissues damage, it was decided to fill the gap with a 2-free-end autograft harvested from the Flexor
Carpi Radialis (FCR) tendon, using the volar surgical approach performed to remove the plate. Results:
At the 2-month follow-up, the patient showed the complete recovery of the flexion-extension movements.
Conclusions: Even though the 2-free-end FCR tendon graft is not commonly reported for the reconstruction
of extensor tendons defects, we assume it deserves to be considered as an adequate technique whenever the
neighbouring tendons are critically compromised.


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