• Lina-Marie Willkomm, Berthold Bickert, and Leila Harhaus.
• Klinik für Hand‑, Plastische und Rekonstruktive Chirurgie, BG Klinik Ludwigshafen, Ludwigshafen, Deutschland. Lina-marie.willkomm@bgu-ludwigshafen.de.
• Unfallchirurg. 2021 Apr 1; 124 (4): 294-302.

BackgroundDue 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.ObjectiveDescription of techniques for secondary reconstruction after extensor tendon injury in zones V-VII.Material And MethodsOverview 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.ResultsWhile 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.ConclusionFor 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.

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