Scar overlapping suture for treating chronic tendinous mallet finger in children

Abstract

Purpose To evaluate the effect of scar overlapping suture for treating chronic tendinous mallet finger deformity in children. Methods Six patients younger than 18 years were investigated retrospectively. The active extensor lags of the distal interphalangeal joint (DIPJ) were all more than 40°, and the passive ranges of DIPJ motion were normal. They were all treated surgically by scar overlapping suture technique, featuring careful overlapping suture of the extensor scar and temporary transarticular Kirschner wire fixation of the DIPJ. Results Average follow-up was 3.1 years (ranging from 2 to 5 years). All patients made significant improvement in DIPJ activity. Three patients achieved full active DIPJ extension, whereas one patient had a 10° extensor lag and two patients had 5° extensor lags. All patients achieved normal active flexion ranges and full passive motion ranges of DIPJ compared with their uninjured side. There was no bone dysplasia, pain, or deformity recurrence. Conclusions Scar overlapping suture for treating chronic tendinous mallet finger in children is safe and effective. According to the Crawford criteria, all patients were graded as excellent.

The Direct Tendon Suture and Paratenon Repair Technique for Acute Tendinous Mallet Finger

“…However, a high level of patient compliance is an essential prerequisite for the successful treatment because the balance of the extensor mechanism tends to be easily disturbed by even a small carelessness. Suboptimal immobilization and distraction of the healing tendon following compliance problem results in a persistent extension lag and a swan-neck deformity [7][8][9].…”