C Brulard1, A Sauvage, O Mares, G Wavreille, C Fontaine. 1. Service d'orthopédie B, hôpital Roger-Salengro, CHRU de Lille, rue Emile-Laine, 59037 Lille cedex, France. charlottebrulard@hotmail.com
Abstract
OBJECTIVES: 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. CONCLUSION: 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.
OBJECTIVES: 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. CONCLUSION: 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.