The junctura lasso: correction of extensor tendon displacement.

Abstract

Recurrent volar displacement of the extensor digitorum communis tendon (EDC) at the metacarpophalangeal joint (MCPJ) more commonly occurs post-trauma or in the rheumatoid hand. This disabling condition of the hand results in painful swelling of the MCPJ, associated with "locking" of the extensor tendon. We report a simple surgical technique used to successfully 'secure' the EDC from recurrent displacement. This was performed for a 59-year-old man who developed the condition in his ring finger, following Vth ray amputation for severe Dupuytren's disease. First, the EDC over the IIIrd and IVth MCPJ are exposed using a longitudinal incision. The junctura tendinum between the EDC tendons was next extended proximally by 2 cm on the radial side of the IVth EDC and then divided to create a distally based junctura slip. Next, a 'lasso' was created by passing the slip beneath the IVth EDC tendon and then securing it onto itself with a 5/0 Ethibond suture (Ethicon Inc.). This reconstruction was then tested in all ranges of MCPJ flexion, successfully preventing volar displacement of the extensor tendon. The 'junctura lasso' provided a satisfactory solution for the patient, who, over the next four years; for the duration of his follow-up, suffered no further displacement of the extensor tendon.

• Authors: Chin Chean Yong, Cara M Connolly, Matt Erdmann
• Journal: Journal of plastic, reconstructive & aesthetic surgery : JPRAS (J Plast Reconstr Aesthet Surg) Vol. 66 Issue 11 Pg. 1610-2 (Nov 2013) ISSN: 1878-0539 [Electronic] Netherlands
• PMID: 23422060 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Topics

• Humans
• Male
• Metacarpophalangeal Joint (physiopathology, surgery)
• Middle Aged
• Secondary Prevention
• Tendon Injuries (surgery)