• Background: Vaughan-Jackson syndrome (VJS) refers to the attritional rupture of extensor tendon rupture at distal radio-ulnar joint, usually in the setting of Rheumatoid arthritis (RA). For the tendon reconstruction, most surgeons prefer the tendon transfer to a relatively healthy extensor tendon. Recently, other modalities such as interposition tendon graft, or direct end-to-end tendon repair have also been reported. We aim to compare the difference of outcome among these treatment options.
• Methods: A retrospective review of medical records from January 2015 to March 2023 was performed, to investigate the RA patients with spontaneous extensor tendon rupture who were treated by tendon transfer or non-tendon transfer (interposition grafting or direct end-to-end repair). Objective evaluation (i.e., extension lag, tip-to-palm distance, length of hospital stay) and subjective assessment (questionnaires about overall hand function, activities of daily living, work, pain, aesthetics, satisfaction) of outcome between tendon transfer group and non-tendon transfer group were compared.
• Results: In total, 22 patients were included, 18 of them received tendon transfer, and 4 received either PL tendon grafting or direct repair. Most of them were diagnosed with more than one extensor tendon ruptured. Both groups presented a minimal extension lag about 5 degrees; although tip-to-palm distance was higher in non-tendon transfer group, no statistical significance was found. However, the hospital stay was 2 days longer or more in non-tendon transfer group. Subjectively, both groups showed comparable improvement in overall hand function and satisfaction at postoperative 3 months and 6 months.
• Conclusion: Both tendon transfer and non-tendon transfer can provide satisfactory outcome without significant difference for the reconstruction of extensor tendon ruptures in VJS.