title: The junctura lasso: correction of extensor tendon displacement.
abstract: Recurrent volar displacement of the extensor digitorum communis tendon (EDC) at the metacarpophalangeal joint (MCPJ) more commonly occurs post-trauma or in the rheumatoid hand. This disabling condition of the hand results in painful swelling of the MCPJ, associated with "locking" of the extensor tendon. We report a simple surgical technique used to successfully 'secure' the EDC from recurrent displacement. This was performed for a 59-year-old man who developed the condition in his ring finger, following Vth ray amputation for severe Dupuytren's disease. First, the EDC over the IIIrd and IVth MCPJ are exposed using a longitudinal incision. The junctura tendinum between the EDC tendons was next extended proximally by 2 cm on the radial side of the IVth EDC and then divided to create a distally based junctura slip. Next, a 'lasso' was created by passing the slip beneath the IVth EDC tendon and then securing it onto itself with a 5/0 Ethibond suture (Ethicon Inc.). This reconstruction was then tested in all ranges of MCPJ flexion, successfully preventing volar displacement of the extensor tendon. The 'junctura lasso' provided a satisfactory solution for the patient, who, over the next four years; for the duration of his follow-up, suffered no further displacement of the extensor tendon.
authors: CT1 Core Surgery, Dewsbury District Hospital, Wakefield WF1 4AF, UK. Electronic address: cchin@nhs.net.
authors: Chin Chean
authors: CC
authors: Yong
authors: Cara M
authors: CM
authors: Connolly
authors: Matt
authors: M
authors: Erdmann
mesh_terms: D006801:Humans; D008297:Male; D008662:Metacarpophalangeal Joint / Q000503:physiopathology / Q000601:surgery*; D008875:Middle Aged; D055502:Secondary Prevention; D013708:Tendon Injuries / Q000601:surgery*
keywords: Extensor digitorum communis; Metacarpophalangeal joint; Surgical technique; Tendon dislocation; Tendon injury