Article
Volar transfer of the lateral band with transverse retinacular ligament is effective for the correction of swan-neck deformity caused by volar plate injury of the PIP joint
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Published: | February 6, 2020 |
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Objectives/Interrogation: Several surgical methods have been performed for the correction of swan-neck deformity. We introduce a novel surgical method for swan-neck deformity caused by volar plate injury of the proximal interphalangeal (PIP) joint.
Methods: A 61-year-old woman presented with swan-neck deformity of her right little finger. She injured her little finger 45 years ago and was diagnosed with volar plate injury of the PIP joint. Snapping of the lateral band was observed when she flexed her finger. Active range of motion was 25° extension of the PIP joint and 20° extension loss of the distal interphalangeal joint (DIP). Passive correction of the deformity was possible and intrinsic tightness test showed no contracture of the lateral band. Conservative treatment with brace was not effective for the correction of the deformity and surgical treatment was selected.
A dorsal incision is made on the PIP joint and both lateral bands were released from the central slip. Bilateral transverse retinacular ligaments were released from the dorsal attachment and elevated with volar base flap. Lateral bands were transferred to the volar side and transverse retinacular ligaments were sutured slightly volar to the original attachment. Intraoperatively, improvement of snapping was confirmed with active flexion of the finger. The PIP joint was immobilized and active motion of the finger was initiated 2 weeks postoperatively.
Results and Conclusions: One year postoperatively, snapping of the lateral band improved with no appearance of swan-neck deformity. Active range of motion of the little finger was 0° of extension and 100° of flexion at the PIP joint, and 0° of extension and 70° of flexion at the DIP joint.
Transfer of the lateral band using transverse retinacular ligament is minimally invasive surgery and effective for swan-neck deformity caused by volar plate injury of the PIP joint.