Y-Shaped Tendon Graft-A Technique in the Reconstruction of Posttraumatic Chronic Boutonniere Deformity
| Autor: | Yu-jie Liu, Xiang Ji, Hongsheng Jiao, Shengquan Ren, Hong-xun Zhang, Xiao-heng Ding |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
Adult Male medicine.medical_specialty Scar tissue 030230 surgery Tendons 03 medical and health sciences Grip strength 0302 clinical medicine Finger Joint Hand Deformities Acquired medicine Humans Orthopedics and Sports Medicine Orthopedic Procedures Range of Motion Articular Tendon graft Retrospective Studies 030222 orthopedics business.industry Mean age medicine.disease Surgery Pip joint Middle phalanx business Range of motion Boutonniere deformity |
| Zdroj: | The Journal of hand surgery. 46(8) |
| ISSN: | 1531-6564 |
| Popis: | Purpose Current reconstruction strategies for chronic posttraumatic boutonniere deformities have variable outcomes and are prone to complications. This study aimed to describe the clinical outcomes of a Y-shaped tendon graft technique. Methods In this retrospective case study, we reviewed the files of 18 patients treated with the Y-shaped tendon graft between January 2010 and January 2017. The technique involves release of the central slip, lateral bands, and transverse retinacular ligaments at the proximal interphalangeal (PIP) joint, total excision of scar tissue in the central slip and at the insertion site, and construction of 3 1.5-mm unicortical holes at the base of the middle phalanx , through which a Y-shaped graft of the palmaris longus is inserted to reconstruct the central slip and stabilize the lateral bands in a dorsal position . Clinical evaluations included measuring the active range of motion in the PIP joint and distal interphalangeal (DIP) joint, grip strength, Souter score, and the Quick Disabilities of the Arm, Shoulder, and Hand ( QuickDASH) score. Results The mean age of patients was 36.1 years, and 12 of the 18 patients were men. The average follow-up period was 23 months (range, 13–38 months). The preoperative PIP joint extension deficit was 48.0° ± 5.0° compared with 10.9° ± 9.3° after surgery. The preoperative DIP joint active flexion was 34.4° ± 8.0° compared with 71.4° ± 8.6° after surgery The outcomes based on the Souter score were 11 excellent, 5 good, and 2 poor. The QuickDASH score was 17.7 ± 6.4 before surgery and 11.2 ± 7.2 after surgery. Conclusions The Y-shaped tendon graft can be a useful procedure for the correction of chronic boutonniere deformity; in our patient series, this provided good or excellent results in 16 of 18 patients. Type of study/level of evidence Therapeutic IV. |
| Databáze: | OpenAIRE |
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