Comparative Study between Lateral Band Mobilization and Spiral Retinacular Ligament Reconstruction in Swan Neck Deformity

Abstract

Background: Sawn neck deformities of the fingers arechallenging and difficult for treatment. Many techniques hadbeen used with different success rates depending on the causeof deformity and the technique used for correction. Techniquesdeal with either lateral band mobilization or oblique retinacularligament reconstruction (ORL) popularly used with manyrefinements.Objectives: To evaluate which surgical maneuver is betterfor correction of swan neck deformity and to compare resultsof lateral band mobilization and oblique retincular ligamentreconstruction.Patients and Method: 11 patients suffered from swanneck deformities. 24 fingers after rheumatoid arthritis, 5post-burn and 3 post-traumatic. Divided into 2 groups, 20fingers were corrected by lateral band mobilization (GroupA). 12 fingers underwent ORL reconstruction (Group B).Assessment was done by measurement of extension lag onDIP by goniometer after 6 months compared with that donepre-operatively.Results: DIP extension lag improved with lateral bandmobilization especially non-rheumatoid patients. But withORL reconstruction the results were not satisfactorty as regardas entension lag and PIP hyperentension.Conclusion: Lateral band mobilization is a reliable methodfor correction of swan neeck deformity especially with nonrheumatoidpatients (burn and trauma), but long-term resultsof lateral band translocation in rheumatoid patients are disappointing,as regard as ORL reconstruction with tendon graft,it did not show satisfactory results in this study.