The Brooks and Graner Procedure for Treatment of Chronic Tendinous Mallet Finger Deformity

Abstract

Most of the mallet finger deformity results from tendinous origin. Many surgical techniques defined for chronic mallet deformity are aggressive, which often result in disappointment. The Brooks and Graner procedure is a developed surgical technique and useful procedure for chronic mallet finger deformity with tendinous origin. The method is simple and very effective for treatment of chronic mallet deformity.

Treatment Options for Mallet Finger: A Review

“…35,36 The most commonly reported techniques in the last decades are tenodermodesis followed by splinting [35][36][37][38] and tenotomy of the central slip. 39 Tenodermodesis consists of the excision of the excessive part of the tendon and skin over the distal interphalangeal joint.…”

“…Overzealous distal soft-tissue dissection may also cause nail plate deformities and skin flap necrosis. 35,38 Other techniques that also shorten the terminal extensor tendon are plication of the elongated tendon, 6 reinsertion of the tendon with a Mitec microbone anchor 41 or pull-through suture, 42 and repair with a tendon graft. 43 The aim of tenotomy of the central slip is to rebalance the extensor mechanism by transecting the insertion of the central slip, thereby transmitting increased extensor force and excursion to the terminal tendon.…”

Comparative Study of Spiral Oblique Retinacular Ligament Reconstruction Techniques Using Either a Lateral Band or a Tendon Graft

“…Active motion exercises were commenced at 3 weeks in both of these studies [1,3]. In a 1984 publication on ORL reconstruction, Kleinman and Petersen [12] reported the fixation of the distal end by a pull-out button anchor and the proximal end to the fibrous rim of fibroosseous canal, with K-wire fixation of the DIP joint.…”

“…Unlike operations designed for acute mallet finger injuries, this latter group of operations has to consider the overall balance of the DIP and PIP joints. On one hand, tendon plication and tenodermodesis can improve a DIP joint extension lag but at the same time may place undue extensor stress on the PIP joint, which over time may contribute to swan-neck deformity [ 3 ]. On the other hand, Fowler release, or central slip tenotomy, allows the extensor mechanism to slide proximally around the PIP joint and does not place undue extensor stress where it is not needed [ 4 ].…”

Lesiones de los tendones extensores

“…Si no existe cuello de cisne, la técnica quirúrgica más utilizada para un dedo en martillo crónico es la descrita por Brooks y Granner: Resección de varios milímetros de piel y del ten- dón. Posteriormente se realiza una tenodermodesis (parecida a la lesión aguda) y por último se fija la IFD con una aguja unas 4-5 semanas 4 (Figura 6).…”