Open AccessFowler Central Slip Tenotomy or Spiral Oblique Retinacular Ligament Reconstruction? A Cadaveric Biomechanical Study in Swan-Neck Deformity
Author(s) -
Christian Deml,
Aslan Baradaran,
Neal C. Chen,
Michael Nasr,
Amir Reza Kachooei
Publication year - 2019
Publication title -
hand
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.722
H-Index - 35
eISSN - 1558-9455
pISSN - 1558-9447
DOI - 10.1177/1558944719834643
Subject(s) - medicine , tenotomy , mallet , deformity , interphalangeal joint , cadaveric spasm , ligament , cadaver , surgery , anatomy , orthodontics , tendon , archaeology , history
Background: The goal of this study is to biomechanically compare Fowler central slip tenotomy with spiral oblique retinacular ligament (SORL) reconstruction in correcting a chronic mallet deformity as part of a swan-neck deformity. Methods: We used 24 human cadaver fingers from 6 hands. Mallet finger and swan-neck deformities were created; then, Fowler tenotomy was done on one group including 3 hands with 12 fingers, and SORL reconstruction was done on the others. Results: During simulated finger extension, there was no significant difference between the 2 techniques in correcting the distal interphalangeal joint droop; however, Fowler tenotomy resulted in hyperflexion of the proximal interphalangeal (PIP) joint, whereas it remained straight after SORL reconstruction. Conclusions: This study supports the SORL reconstruction in correcting a chronic mallet deformity, especially when there is a concomitant PIP hyperextension deformity, which lowers the risk of reversing the deformity after a Fowler procedure.