Extensor Tendon Centralization of the Metacarpophalangeal Joint Using a Synthetic Suture Tape

Extensor tendon subluxation secondary to sagittal band instability may be treated with splinting, direct repair, imbrication, or sagittal band reconstruction. However, prior techniques often rely on the quality of the native soft tissues or may not allow for multiple reconstructions at once. We present a technique using a synthetic suture tape that creates a new pulley over the MCP joint to centralize the EDC tendon that does not rely on the quality of the native soft tissues or autograft, avoids the potential for stretching of a tendinous graft reconstruction over time, and allows for reconstruction of multiple digits at the same time or multiple pulley reconstructions for the same digit at the same time.