title: Surgical technique: hemi-extensor carpi radialis brevis tenodesis for stabilizing the midcarpal joint in Ehlers-Danlos syndrome.
abstract: Patients with the hypermobility type of Ehlers-Danlos (EDS-HT) often complain of wrist pain, usually originating from subluxations. As a result of the laxity, wrist function in these patients can be highly limited. This paper presents a surgical technique that stabilizes the lunocapitate joint with the use of an extensor carpi radialis brevis strip. Five patients with confirmed EDS-HT were treated with an extensor carpi radialis brevis tenodesis for their midcarpal instability. Two patients presented with complications following surgery, one major and one minor. This paper presents a potentially satisfactory surgical solution to recurrent midcarpal instability in EDS-HT patients and demonstrates that the use of an autologous tendon might be feasible in spite of a background of abnormal collagen metabolism.
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam; Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Plastic Surgery, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom. Electronic address: davidkrijgh@gmail.com.
authors.forename: David D
authors.initials: DD
authors.lastname: Krijgh
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam; Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Plastic Surgery, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
authors.forename: Oliver J
authors.initials: OJ
authors.lastname: Harley
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam; Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Plastic Surgery, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
authors.forename: Steven E
authors.initials: SE
authors.lastname: Hovius
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam; Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Plastic Surgery, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
authors.forename: J Henk
authors.initials: JH
authors.lastname: Coert
authors.affiliation: Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center, Rotterdam; Department of Plastic Surgery, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Plastic Surgery, Oxford Radcliffe Hospitals NHS Trust, Oxford, United Kingdom.
authors.forename: Erik T
authors.initials: ET
authors.lastname: Walbeehm
mesh_terms: D000328:Adult; D050824:Carpal Joints / Q000033:anatomy & histology / Q000601:surgery*; D004535:Ehlers-Danlos Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology / Q000517:prevention & control; D007593:Joint Instability / Q000209:etiology / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D053656:Tenodesis; D055815:Young Adult
keywords: Ehlers-Danlos syndrome; extensor carpi radialis brevis; midcarpal instability; surgery; tenodesis