The results of treatment for isolated zone 3 extensor tendon injuries

Objectives: We evaluated late-term results of surgical re¬pair and physical rehabilitation of isolated zone 3 extensor tendon injuries. Methods: Sixteen patients (13 males, 3 females; mean age 28 years; range 11 to 57 years) underwent surgical repair for isolated simple central slip injuries of zone 3 extensor tendon. Injuries involved the second, third, fourth, and fifth fingers in seven, three, two, and four patients, respectively. Primary ten¬don repair was performed in 14 patients. Two patients were treated after one week and two months following primary in¬jury, respectively. Tendons were repaired by modified Kessler and epitendinous sutures in four patients, and by locking run¬ning suture in 12 patients. Following surgical repair, three pa¬tients underwent K-wire fixation in extension for two weeks, while 13 patients received the short arc motion protocol. The patients were assessed with respect to proximal interphalan- geal (PIP) joint motion and extension loss. Functional results were assessed using the Strickland formula. The mean fol¬low-up was 58 months (range 8 to 120 months). Results: Full range of motion of the PIP joint was achieved in 15 patients (93.8%). The mean PIP joint motion was 98 degrees. One patient (6.3%) had an extension loss of 10 degrees in the range of motion of the PIP joint. There were no losses in the range of motion in three patients treated with K-wire fixation. The mean of the Strickland formula was 94.8% (range 74% to 100%), showing an excellent result in 15 patients (98.3%) and a good result in one patient (6.3%). All the patients returned to their pre-injury work status. None had buttonhole deformity or soft tissue complication. Conclusion: A proper suture technique combined with the short arc motion protocol provides good results in the treat¬ment of isolated zone 3 extensor tendon injuries.