title: Number of ruptured tendons and surgical delay as prognostic factors for the surgical repair of extensor tendon ruptures in the rheumatoid wrist.
abstract: OBJECTIVE
  Extensor tendon ruptures in the rheumatoid wrist are usually restored by extensor tendon reconstruction surgery. However, the factors significantly correlated with the outcomes of extensor tendon reconstruction have not been defined. We examined factors showing a statistically significant correlation with postoperative active motion after tendon reconstruction.
  
  
  METHODS
  Spontaneous extensor tendon ruptures of 66 wrists in patients (mean age, 52.6 yrs) with rheumatoid arthritis (RA) were evaluated. All patients underwent tendon reconstruction surgery with wrist arthroplasty or arthrodesis. Active ranges of motion of the affected fingers were evaluated at 12 weeks postsurgery. Statistical significance was determined using multiple and single regression analyses.
  
  
  RESULTS
  Forty-six (69.6%) wrists had "good" results, while 13 (19.7%) and 7 (10.6%) wrists had "fair" and "poor" results, respectively. In multiple regression analysis, an increased number of ruptured tendons and the age at operation were independent variables significantly correlated with the postoperative active motion of reconstructed tendons (p = 0.009). Single regression analysis also showed a significant association between the number of ruptured tendons and surgical delay (p = 0.02).
  
  
  CONCLUSIONS
  The number of ruptured extensor tendons was significantly correlated with the results of tendon reconstruction, and the number of ruptured tendons was significantly correlated with preoperative surgical delay. Our results indicate that, in patients presenting with possible finger extensor tendon rupture, rheumatologists should consult with hand surgeons promptly to preserve hand function.
authors.affiliation: From the Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Kensuke
authors.initials: K
authors.lastname: Ochi
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwamoto
authors.forename: Asami
authors.initials: A
authors.lastname: Saito
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yano
authors.forename: Yurino
authors.initials: Y
authors.lastname: Naito
authors.forename: Shinji
authors.initials: S
authors.lastname: Yoshida
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikari
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D001178:Arthroplasty; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology*; D012422:Rupture, Spontaneous / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D013708:Tendon Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014955:Wrist Joint / Q000503:physiopathology / Q000601:surgery*
keywords: EXTENSOR TENDON RUPTURE; NUMBER OF RUPTURED TENDONS; RECONSTRUCTION; RHEUMATOID ARTHRITIS; SURGICAL DELAY; SURGICAL REPAIR