Journal of Rheumatic Diseases

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Fig. 1. Reconstruction options for ruptured extensor tendon in rheumatoid arthritis according to the involved fingers. (A) For involvement of the little finger only, the extensor digitorum minimi (EDM) function is restored by reattaching its distal part to the 4th extensor digitorum communis (EDC) by end-to-side suture, so that the 4th EDC can extend both the 4th and 5th fingers. (B) For involvement of the little and 4th finger, the 4th EDC function is restored by reattaching its distal part to the 3rd EDC by end-to-side suture, so that the 3rd EDC can extend both the 3rd and 4th fingers. The EDM function is restored by transferring the extensor indicis proprius (EIP) by end-to-end suture, so that the EIP can extend the little finger instead of the index finger. The remaining 2nd EDC extends the index finger without the EIP. (C) Involvement of the little, 4th, and 3rd finger is difficult to treat satisfactorily. The authors’ favorite method is to restore the EDM function by transferring the EIP to the EDM by end-to-end repair, and to restore the 3rd and 4th EDCs by transferring the extensor carpi radialis longus (ECRL, wrist extensor) by end-to-end suture (Drawings are authors’ own artwork).
J Rheum Dis 2021;28:192~201 https://doi.org/10.4078/jrd.2021.28.4.192
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