The correction of boutonniere deformity by tenodesis of the bilateral slips of the flexor digitorum superficialis tendon
10.3760/cma.j.cn114453-20220718-00222
- VernacularTitle:双侧等长指浅屈肌腱外侧腱束治疗纽扣指畸形
- Author:
Qiting JIANG
1
;
Zhi LI
;
Hong YU
;
Zhigang WANG
;
Wei FANG
;
Tao LI
Author Information
1. 南京江北医院手足显微外科，南京 210048
- Keywords:
Finger;
Boutonniere deformity;
Tendon repair;
Surgery
- From:
Chinese Journal of Plastic Surgery
2023;39(3):278-284
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical efficacy of the treatment of boutonniere deformity by tenodesis of the bilateral slips of the flexor digitorum superficialis (FDS) tendon.Methods:From February 2021 to May 2022, the boutonniere deformity was retrospectively analyzed, by tenodesis of the bilateral slips of the FDS in the Department of Hand and Foot Microsurgery of Nanjing Jiangbei Hospital.During the operation, the lateral side of the bilateral FDS was split at the distal end separately. Then the two bundles were tunneled through the bone of the middle phalanx and weaved with the central band of the extensor tendon. The involved finger was stabilized in extension with splinting for 4 weeks after surgery. Extension and flexion of the proximal interphalangeal joint(PIPJ) of the finger should be gradually strengthened. Finger function was evaluated according to the total action movement (TAM) system of the American Association of Hand Surgeons.Results:A total of 7 patients (7 digits) were enrolled, including 5 males and 2 females, and the age ranged from 22 to 64 years old, with an average age of 42 years old. The injured included 1 index finger, 2 middle fingers, 2 ring fingers, and 2 little fingers. These patients were follow-up for 6 to 8 months with an average of 7 months. All wounds healed by primary intention. This operation can obtain the complete correction of the boutonniere deformity. The PIPJ was stable and capable of active flexion and straightness. The straightness of PIPJ and distal interphalangeal joint was improved. The mean active motion of the PIPJ of the affected finger was 92.4°, and the mean TAM of the affected finger was 271.3°. According to TAM system assessment criteria: excellent in 6 patients, good in 1 patient.Conclusion:It is a safe and effective new method for the correction of boutonniere deformity, which can be effectively treated with tenodesis of the bilateral slips of the FDS.
