Buttonhole Deformity

Hg, Stack

doi:10.1016/0072-968x(71)90034-9

Cited by 34 publications

(8 citation statements)

References 18 publications

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“…This is sooner than normal digits which undergo epiphyseal fusion in adolescence. 22,23 Due to a paucity of literature and short reported follow-up times, the rate of premature physeal closure in pediatric digital joint transfer is not well understood. This is true for both nonvascularized and vascularized transfers.…”

Section: Discussionmentioning

confidence: 99%

Nonvascularized Toe Joint Transfers to the Hand in Young Children: Technique Revisited

Trost

Kaufman

Netscher

2020

Hand (New York, N,Y.)

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Background: Small joint reconstruction of the hand poses a significant challenge, especially in children where both functional motion and preservation of the epiphysis are desired. Auto-transplantation of whole joints is the only way to reconstruct a functional joint that maintains growth potential. Historically, nonvascularized toe-to-finger joint transfer has been criticized for high rates of avascular necrosis and joint dissolution, while vascularized transfers seemingly resulted in increased durability of the joint space and epiphysis. However, certain populations remain poor candidates for microvascular reconstruction, such as those with congenital deformities or sequelae from trauma or infection. In our case series, we demonstrate that a simplified nonvascularized surgical technique and careful patient selection can produce stable, functional joints. Methods: Nonvascularized toe-to-finger joint transfer was performed in 3 children between the ages of 4 and 6. Reconstructed joints included 2 proximal interphalangeal (PIP) joints and 1 metacarpophalangeal (MCP) joint. Donor grafts consisted of second toe PIP joints harvested en bloc to include the epiphysis of the middle phalanx, collateral ligaments, volar plate, and a diamond-shaped island of extensor tendon with its central slip attachment. Results: Follow-up ranged from 7 to 29 months. Each patient demonstrated functional improvements in joint motion and stability. Postoperative radiographs confirmed adequate joint alignment and persistence of the joint spaces. Epiphyseal closure was observed in 1 patient as early as 25 months postoperatively. Conclusions: Nonvascularized joint transfer should remain a practical consideration for small joint reconstruction of the hand in certain pediatric patients.

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Section: Discussionmentioning

confidence: 99%

Nonvascularized Toe Joint Transfers to the Hand in Young Children: Technique Revisited

Trost

Kaufman

Netscher

2020

Hand (New York, N,Y.)

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“…All or part of the FDS is rerouted in order to reconstruct the central slip [3,16]. Another option is to divert the lateral slip from an adjacent finger [1].…”

Section: Discussionmentioning

confidence: 99%

“…The various repair techniques described for such tendon defects (tendon plasty, graft, transfer) are generally used in secondary posttraumatic lesions [1][2][3]. Oberlin described a procedure where a free tendon is grafted onto the extensor indicis muscle in cases of chronic, posttraumatic boutonniere deformity [4].…”

Section: Introductionmentioning

confidence: 99%

Emergency repair of extensor tendon central slip defects with Oberlin's bypass technique: Feasibility and results in 4 cases with more than 5years of follow-up

Feuvrier¹,

Loisel²,

Pauchot³

et al. 2014

Chirurgie de la Main

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“…All of the previous techniques for the reconstruction of BDD utilized nonvascularized palmaris longus tendon grafts as the primary donor source. The exception is a flexor digitorum superficialis technique with a drill hole thru the middle phalanx, described by Stack in 1971 [ 9 ]. This case report is the first to demonstrate the FDP tendon as a donor source for the reconstruction of the central extensor tendon at the PIP joint with the added advantage of single-stage soft tissue coverage.…”

Section: Discussionmentioning

confidence: 99%

Vascularized tendon graft to the central slip using a finger fillet flap

Rogozinski

Johnson

2020

Journal of Surgical Case Reports

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Abstract Burn boutonniere deformity (BBD) treatment remains a challenge in reconstructive surgery. Severe hand defects after burn/trauma may be reconstructed with nonsalvageable or amputated tissue. The fillet flap (FF) is generally used as “spare parts” in the trauma algorithm for mangled extremities. This case study examines the use of a FF with concurrent repair of the adjacent finger extensor tendon with the amputated finger flexor tendon after burn injury. The goal is to provide adequate tissue coverage using a finger FF while concurrently reconstructing the central slip of the extensor tendon with the transposed flexor tendon from an adjacent nonfunctional digit. After reconstruction, no subluxation of the extensor tendon occurred with manipulation. Despite prolonged rehabilitation due to injuries, the surgical site healed appropriately. Single-stage FF reconstruction with vascularized tendon grafts should be considered in selected patients with BBD. This novel idea can be applied to the management of traumatized extremities.

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Buttonhole Deformity

Cited by 34 publications

References 18 publications

Nonvascularized Toe Joint Transfers to the Hand in Young Children: Technique Revisited

Nonvascularized Toe Joint Transfers to the Hand in Young Children: Technique Revisited

Emergency repair of extensor tendon central slip defects with Oberlin's bypass technique: Feasibility and results in 4 cases with more than 5years of follow-up

Vascularized tendon graft to the central slip using a finger fillet flap

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