Chronic Boutonniere Deformity: Cross-Lateral Band Technique Using Palmaris Longus Autograft

Area of Science:

• Orthopedic surgery
• Hand surgery
• Reconstructive surgery

Background:

• Chronic boutonniere deformity often involves damaged or deficient lateral bands.
• Restoring lateral band integrity is crucial for correcting this deformity.

Purpose of the Study:

• To evaluate the outcomes of a novel reconstruction technique for chronic boutonniere deformity.
• The technique utilizes a palmaris longus autograft to reconstruct deficient lateral bands.

Main Methods:

• Seven patients with chronic, posttraumatic, flexible boutonniere deformities underwent the novel reconstruction.
• Palmaris longus tendon grafts were used to reconstruct the lateral bands, crossing at the middle phalanx.
• Outcomes were assessed by measuring the range of motion of the proximal and distal interphalangeal joints.

Main Results:

• Average active flexion of the proximal interphalangeal (PIP) joint improved from 69° to 92°.
• PIP joint extension deficit decreased from an average of 54° to 7°.
• Distal interphalangeal (DIP) joint hyperextension was reduced, and active flexion improved post-surgery.

Conclusions:

• The cross-lateral band reconstruction technique using palmaris longus autograft yields satisfactory results for chronic boutonniere deformity.
• This technique is a viable treatment option when lateral bands are deficient or damaged.