[Surgical treatment of chronic mallet finger by shortening--suture of the tendon scar. Sixty six cases].
Acute mallet fingers are commonly treated by splinting. Treatment of chronic injuries is more debated. Since 1989, a "shortening and suture" technique have been used for such chronic injuries on the elongated tendon scar. Sixty six of 77 patients treated on a 10 years period were reviewed with a mean follow-up of 21 months. The mean active extension lag at the distal interphalangeal (DIP) joint was 4.5 degrees (41 degrees of improvement) with 52% of fingers which recovered a full extension, representing 77% of good and excellent results according to Abouna's and Brown's modified criteria. There were two failures which lead to reoperation, and no complication (2 painful scars and 20% of cold intolerance). We propose this safe and simple technique for chronic mallet fingers if deformity exceeds 30 degrees, for patients untreated (after the second month), or when splinting has failed. "Swan-neck" deformities were improved by an associated Fowler procedure. In case of failure, a new "shortening and suture" or a DIP arthrodesis can be discussed.
Service de chirurgie orthopédique et traumatologique, Pr J.Y.-Nordin, centre hospitalier universitaire de Bicêtre, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
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Levante
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Belkadi
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Ebelin
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001864:Bone Wires; D002908:Chronic Disease; D002921:Cicatrix / Q000150:complications* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006227:Hand Deformities, Acquired / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011859:Radiography; D016059:Range of Motion, Articular; D012086:Reoperation; D013536:Suture Techniques; D013708:Tendon Injuries / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome