Reconstruction of the Central Slip by the Transverse Retinacular Ligament for Boutonnière Deformity

Abstract

A method of repair of boutonnière deformity is described, using the transverse retinacular ligament. Six fingers in five patients were treated by this procedure. The deformity was improved in all fingers; complete or almost complete correction was obtained in four fingers and incomplete correction in two. However, severe limitation of flexion of the D.I.P. joint appeared in two fingers after surgery. This procedure is not indicated for boutonnière deformities with severe contracture of the lateral band; its best indication is in cases in which the central slip is defective and conservative treatment is not effective.

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

“…Ohshio et al used the transverse retinacular ligament; they had good outcomes and were able to correct volar migration of lateral slips [17]. Le Dû performed PIP reconstruction with a retinaculum-boneretinaculum graft taken from the dorsal side of the wrist [18].…”

Boutonniere Deformity

“…Ohshio et al 16 described a technique that involved releasing the transverse retinacular ligaments from the palmar plate and suturing them together dorsally. In 4 digits, 3 improved to an extensor deficit of 5°and the other digit had a 20°extensor deficit.…”

Treatment of chronic extensor tendons lesions of the fingers

“…Longitudinal division of lateral slips into two continuous half-slips that are brought to the midline; they are sutured together and secures to the CS insertion (Littler-Burkalter-Aiache) [63,64]; two central slips, which are previously separated from the lumbricals and ORL, are turned-over dorsally, divided distally and then sutured to each other and secured to the P2 base [62] (Littler-Eaton); TRL division just above with the volar plate, which is then folded-over dorsally and sutured together [65].…”