[Secondary reconstruction in zones V-VII in extensor tendon injuries].

BACKGROUND Due to various functional impairments after primary extensor tendon repair or lack of treatment, secondary tendon reconstruction is often required. Anatomical considerations, the outcome of the injury and its treatment and the patients' individual demands on the function of the hand affect the choice of the procedure. OBJECTIVE Description of techniques for secondary reconstruction after extensor tendon injury in zones V-VII. MATERIAL AND METHODS Overview of surgical treatment concepts for secondary extensor tendon repair in zones V-VII of the extensor tendons of the fingers and thumb. Discussion of alternative surgical techniques for secondary extensor tendon repair. RESULTS While techniques for reconstruction of sagittal band injuries are predominant in zone V, side-to-side tendon transfers, the use of tendon grafts and end-to-end tendon transfers prevail in zones VI-VII. The reconstruction of the extensor pollicis longus tendon function using transfer of the extensor indicis proprius tendon is the standard procedure. CONCLUSION For secondary repair of an extensor tendon function, anatomical features and functional interaction of the extrinsic and intrinsic hand musculature need to be considered depending on the zone affected.