[Treatment of rheumatoid swan neck deformity by tenodesis of proximal interphalangeal joint with a half flexor digitorum superficialis tendon. About 23 fingers at 61 months follow-up].
OBJECTIVE
Surgical treatment of finger swan neck deformities is versatile. We aimed to assess the outcome of PIP tenodesis on unfixed deformities, in patients suffering from rheumatoid arthritis.


METHODS
Twenty-three PIP tenodeses were performed on eight patients, using half of a superficialis flexor digitorum tendon sutured to A2 pulley through a volar approach. Postoperative splinting, in 20° of PIP flexion, was maintained for 4 weeks. The patients were assessed retrospectively, at a mean period of 61 months.


RESULTS
The PIP flexion gained 26°. On the other hand, a 4°-flexion contraction was induced. The mean postoperative flexion reached 65°. The PIP hyperextension was corrected by 33°. In one same patient, the correction was insufficient for the four fingers. The DIP lack of extension was totally corrected in 70% of the cases and partially in 30%. Each patient had functional improvement. Nineteen good and excellent, and four fair results were reported. No major complication was observed.


CONCLUSIONS
This tenodesis seems to be reliable and to give good long-term results. It is our intervention of choice for rheumatoid flexible swan-neck deformity.
Service d'orthopédie B, hôpital Roger-Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille cedex, France. charlottebrulard@hotmail.com
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Brulard
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Sauvage
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Mares
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Wavreille
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Fontaine
D000328:Adult; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000601:surgery*; D005260:Female; D005384:Finger Joint; D005500:Follow-Up Studies; D006227:Hand Deformities, Acquired / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013710:Tendons / Q000601:surgery*; D053656:Tenodesis; D013997:Time Factors