Chronic Traumatic Sagittal Band Injury with Extensor Tendon Dislocation: Report of a Case and New Surgical Technique.

Or Sy,Khaw Yc,Hwang Px,Ong Tk

doi:10.5704/moj.1707.007

Abstract

Chronic sagittal band injury with tendon dislocation of the extensor digitorum communis in the hand often requires operative stabilization. Various surgical techniques have been reported to repair and reconstruct the sagittal band. Nonetheless, most of the techniques are technically demanding and require donor graft. In this case report, we report a novel surgical technique to centralize and stabilize the tendon by reattaching the radial sagittal band with anchor sutures. The advantages of this new technique are simple, no donor morbidity and stable repair to restore the normal biomechanics of the tendon. The patient was able to return to work in three months and no recurrent dislocation was noted at review two years after surgery.

Highlights

Sagittal band injury with dislocation of the extensor digitorum communis tendon (EDC) is rare
We describe a new surgical technique in this case, whereby the radial sagittal band was anchored into the metacarpal head without donor tendon
A new surgical method was devised based on the classic technique of realignment of EDC tendon and repair of the sagittal band defect

Summary

INTRODUCTION

Sagittal band injury with dislocation of the extensor digitorum communis tendon (EDC) is rare. It is frequently associated with blunt trauma. Middle finger is the most commonly affected[1]. The clinical presentation includes pain, swelling and snapping over the affected knuckle associated with limitation in finger flexion. Most of the reconstructive surgeries reported in literature require tendon graft from lumbricals, juncturae tendinum, extensor tendon or palmaris longus. We describe a new surgical technique in this case, whereby the radial sagittal band was anchored into the metacarpal head without donor tendon

CASE REPORT

Outcome parameter

DISCUSSION