Extensor Carpi Radialis Longus Tendon Transfer to Extensor Carpi Ulnaris: Does It Significantly Improve the Correction of Radial Deviation in the Rheumatoid Wrist?

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Mariano Oscar Abrego
Fernando Holc
Ignacio Rellán
Agustín Guillermo Donndorff
Gerardo Luis Gallucci
Jorge Guillermo Boretto
Pablo De Carli

Abstract

Introduction: Inflammatory arthritis can lead to caput ulnae syndrome with radial deviation of the wrist and metacarpals. Treatment includes salvage arthroplasty of the distal radioulnar joint and relocation of the extensor carpi ulnaris (ECU) tendon. However, the ECU may be too weak to correct the deviation. To strengthen the ECU, Clayton described the transfer of the extensor carpi radialis longus (ECRL) tendon to the ECU. The aim of this work is to compare the correction of the radial deviation of the metacarpals in patients with and without transfer of the ECRL to the ECU.
Materials and Methods: Retrospective cohort study. Patients with rheumatoid arthritis and caput ulnae syndrome, treated with ECU tenoplasty with or without ECRL, were included. The patientswere divided into two groups: ECRL to ECU transfer (group A) and no transfer (Group B). The correction of the metacarpal-radial angle (Clayton’s angle) was calculated by comparing the measurements before surgery and at end of follow-up, and the results obtained were compared.
Results: The average follow-up was 28 months. The preoperative Clayton angle was on average 44.54° (SD ± 7.52) in group A and 60.24° (SD ± 12.28) in group B (p = 0.001). The correction average was 6.57° (SD ± 4.11) and 0.95° (SD ± 9.17) for group A and B respectively (p=0.026).
Conclusions: The level of correction obtained was higher in group A. However, although both techniques managed to improve the angle, the degree of correction could be subject to the magnitude of the preoperative angle.

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How to Cite
Abrego, M. O., Holc, F., Rellán, I., Donndorff, A. G., Gallucci, G. L., Boretto, J. G., & De Carli, P. (2023). Extensor Carpi Radialis Longus Tendon Transfer to Extensor Carpi Ulnaris: Does It Significantly Improve the Correction of Radial Deviation in the Rheumatoid Wrist?. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 88(6), 594-600. https://doi.org/10.15417/issn.1852-7434.2023.88.6.1722
Section
Clinical Research
Author Biographies

Mariano Oscar Abrego, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Fernando Holc, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Ignacio Rellán, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Agustín Guillermo Donndorff, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Gerardo Luis Gallucci, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Jorge Guillermo Boretto, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Pablo De Carli, Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

Orthopedics and Traumatology Service, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

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