HS12P THE DONA TECHNIQUE FOR FDP AND EDC TENDON FIXATION TO THE DISTAL PHALANX

Abstract

Purpose: Common methods of repair of zone 1 flexor digitorum profundus (FDP) or extensor tendon avulsion or laceration are the modified Bunnell pullout and suture anchor techniques. While these techniques have extensive use clinically, results show a 75% fair to poor outcome. We present a simple technique for repairing these injuries and discuss its rationale.Methodology: A retrospective analysis was undertaken on a consecutive cohort of 5 patients that were treated by the relatively simple method of (1) securing the FDP tendon stump with a 4‐0 Fibreloop suture in a standard Kessler suture configuration (2) creation of transosseous tunnels and (3) passing the sutures through the base of the distal phalanx and then tying them volar to the FDP tendon stump, which effectively results in a 4 strand tendon and 4 strand transosseous suture repair.Results: Six month follow up of MCP, PIP, and DIP joint flexion was 99%, 95%, and 86% of that of the uninjured side, respectively, with no complications. All patients were able to return to their pre‐injury level of functioning and employment, with no further operations required. This technique has also been employed when repairing open mallet finger injuries. Additionally, similar principles are used when repairing volar plate avulsion injuries.Conclusion: The technique avoids the morbidity associated with both the pullout button and suture anchor techniques, while providing an inexpensive, and highly reproducible, four‐strand biomechanically sound repair that allows an early active mobilization protocol to maximize return of function.