title: The morbidity of the button-over-nail technique for zone 1 flexor tendon repairs. Should we still be using this technique?
abstract: The button-over-nail technique is commonly used to fix the core suture to the distal phalanx for flexor digitorum profundus repairs in zone 1. We report a retrospective study of 23 consecutive patients who had a repair of the flexor digitorum profundus tendon in zone 1 using the button-over-nail technique. Fifteen patients experienced a complication, of which ten were directly related to the button-over-nail technique. Complications included nail deformities, fixed flexion deformities of the distal interphalangeal joint, infections and prolonged hypersensitivity. Two patients required amputation of the fingertip. We recommend that the button-over-nail technique should be avoided or used only with caution and with close attention to the details of the technique.
authors.affiliation: Department of Plastic Surgery, Mount Vernon Hospital, Northwood, Middlesex, UK. mrkang@connectfree.co.uk
authors.forename: N
authors.initials: N
authors.lastname: Kang
authors.forename: D
authors.initials: D
authors.lastname: Marsh
authors.forename: D
authors.initials: D
authors.lastname: Dewar
mesh_terms: D000293:Adolescent; D000328:Adult; D000671:Amputation, Surgical; D002648:Child; D015331:Cohort Studies; D005260:Female; D005383:Finger Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000601:surgery; D016059:Range of Motion, Articular; D012086:Reoperation; D012189:Retrospective Studies; D013708:Tendon Injuries / Q000601:surgery*; D053656:Tenodesis / Q000009:adverse effects* / Q000379:methods*; D017211:Treatment Failure; D055815:Young Adult