Direct repair of the sagittal band for extensor tendon subluxation caused by finger flicking.

Abstract

For patients with metacarpophalangeal (MCP) extensor tendon subluxation caused by finger flicking injury, we performed an extensor tendon realignment and direct repair technique. The purpose of this study was to evaluate the clinical outcome after direct repair of the sagittal band in patients with MCP extensor tendon subluxation caused by finger flicking injury and to introduce the repair technique. Atotal of 26patients with a mean age of 39.9 years were included in the study. The mean time from injury to surgery was 51.3 days. The ruptured sagittal band was reattached to the lateral side of the extensor tendon using acontinuous interlocking suture. Patients were evaluated for pain using avisual analog scale (VAS), range of motion, long fingertip pinch strength, disabilities of the arm, shoulder, and hand (DASH) score, and the recurrence of extensor tendon subluxation or dislocation. All patients had full range of motion compared to the uninjured contralateral digit. Long fingertip pinch strength was also comparable to that of the contralateral digit in all patients. The DASH score was also improved from a preoperative average of 28.8 to a postoperative average of1.0. Realignment of the extensor tendon and direct repair of the superficial layer of the sagittal band to the extensor digitorum communis (EDC) tendon is recommended as atreatment option in patients with chronic MCP extensor tendon subluxation, as well as for acute MCP extensor tendon subluxation in patients that have failed or could not maintain conservative treatment approaches.