Abstract
PurposeTo evaluate the effect of scar overlapping suture for treating chronic tendinous mallet finger deformity in children.MethodsSix patients younger than 18 years were investigated retrospectively. The active extensor lags of the distal interphalangeal joint (DIPJ) were all more than 40°, and the passive ranges of DIPJ motion were normal. They were all treated surgically by scar overlapping suture technique, featuring careful overlapping suture of the extensor scar and temporary transarticular Kirschner wire fixation of the DIPJ.ResultsAverage follow-up was 3.1 years (ranging from 2 to 5 years). All patients made significant improvement in DIPJ activity. Three patients achieved full active DIPJ extension, whereas one patient had a 10° extensor lag and two patients had 5° extensor lags. All patients achieved normal active flexion ranges and full passive motion ranges of DIPJ compared with their uninjured side. There was no bone dysplasia, pain, or deformity recurrence.ConclusionsScar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective. According to the Crawford criteria, all patients were graded as excellent.
Highlights
Mallet finger deformity is caused by a loss of continuity of the extensor tendon over the distal interphalangeal joint (DIPJ) or a fracture of the base of distal phalanx [1, 2], which were called “tendinous mallet finger” and “bony mallet finger,” respectively [1, 3]
When splinting cannot correct the deformity or when more than 4 weeks have passed since the injury, the mallet finger is considered chronic [4, 5]
Splinting is the first choice to treat chronic tendinous mallet finger [4], but surgery can be considered when there is an extensor lag over 40° or if there is a functional deficit [6, 7]
Summary
Mallet finger deformity is caused by a loss of continuity of the extensor tendon over the distal interphalangeal joint (DIPJ) or a fracture of the base of distal phalanx [1, 2], which were called “tendinous mallet finger” and “bony mallet finger,” respectively [1, 3]. Splinting is the first choice to treat chronic tendinous mallet finger [4], but surgery can be considered when there is an extensor lag over 40° or if there is a functional deficit [6, 7]. Several surgical techniques have been adopted for treating chronic tendinous mallet finger, such as tenodermodesis, central slip tenotomy, oblique retinacular ligament, and even arthrodesis [8,9,10]. This investigation was conducted to assess another
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