Percutaneous Tenodermodesis for Mallet Fingers: An Office-based Procedure

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Injuries

Background:

• Mallet finger injuries involve the extensor tendon at the distal interphalangeal (DIP) joint, presenting as bony or soft tissue avulsions.
• Traditional non-bony mallet finger treatment involves 6-8 weeks of splinting in extension, with potential complications like poor compliance and suboptimal outcomes.
• Achieving optimal outcomes requires effective joint immobilization and patient adherence, which can be challenging with conventional splinting methods.

Purpose of the Study:

• To present a novel percutaneous tenodermodesis technique for treating non-bony mallet finger injuries.
• To evaluate the efficacy and outcomes of this minimally invasive office-based procedure.
• To demonstrate a method that ensures joint reduction and immobilization, improving patient compliance and functional results.

Main Methods:

• A percutaneous tenodermodesis procedure was performed using a digital block and 4.0 nylon suture.
• This office-based technique achieves joint reduction and immobilizes the distal interphalangeal (DIP) joint.
• Suture removal occurred after 8 weeks, followed by active mobilization of the DIP joint.

Main Results:

• Eight patients with mallet finger injuries were treated, with a mean follow-up of 3 months.
• The mean initial extension lag was 32 degrees, significantly reduced to a mean final lag of 2 degrees.
• Excellent outcomes were observed in all patients according to the Crawford criteria.

Conclusions:

• Percutaneous tenodermodesis is an effective and minimally invasive treatment for non-bony mallet finger injuries.
• This technique provides reliable joint immobilization, leading to excellent functional recovery and minimal residual extension lag.
• The procedure offers a viable alternative to traditional splinting, improving outcomes and patient management for mallet finger deformities.