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Kirners deformity - a systematic review and surgery recommendations.

Tim Fülling¹, Carsten Baade², Adrian Dragu¹

¹Abteilung für Plastische und Handchirurgie UniversitätsCentrum für Orthopädie, Unfall- & Plastische Chirurgie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany.

Archives of Orthopaedic and Trauma Surgery

|January 3, 2025

Summary

Kirner deformity, a rare little finger anomaly in adolescents, often requires surgical intervention, specifically flexor digitorum profundus (FDP) tendon detachment, for optimal functional and aesthetic outcomes, particularly when treated before age 12.

Keywords:

Dystelephalangy Finger deformity Hand surgery Kirners deformity Surgery recommendations

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Area of Science:

Orthopedics
Pediatric Surgery
Hand Surgery

Background:

Kirner deformity is a rare adolescent little finger anomaly characterized by distal phalanx abnormalities and L-shaped epiphysis.
Systematic reviews are lacking due to the condition's rarity, necessitating an overview of its clinical aspects and treatments.

Approach:

Presents five surgical cases of Kirner deformity treated with flexor digitorum profundus (FDP) tendon partial tenotomy and, in one case, dorsal epiphysiodesis.
Conducts a systematic literature review to summarize prevalence, epidemiological data, and surgical treatment options for Kirner deformity.

Key Points:

Kirner deformity affects females more than males (63% vs. 36%) with an average age of presentation at 9.36 years.
The deformity is frequently bilateral (over 50% of cases).
Surgical intervention (FDP detachment or osteotomy) is performed in only 7.4% of cases, with over 90% receiving conservative treatment.

Conclusions:

Surgical detachment of the FDP tendon is recommended for Kirner deformity with functional limitations or pain.
Conservative therapy with corrective splinting is suitable for incidental findings without functional impairment.
Early surgical treatment before age 12 enhances long-term functional and aesthetic results.