Bone-Anchored Tendon Autograft for Sutureless Digital Extensor Tendon Stabilization After Sagittal Band Injury

Digital extensor tendon instability or subluxation occurs in the setting of a sagittal band injury, which allows the extensor to subluxate off the metacarpal head upon flexion at the metacarpophalangeal joint. This can cause painful snapping of the tendon and limit the initiation of active extension. Surgical tendon stabilization is appropriate for patients who fail initial nonoperative splint immobilization after acute injury or those with chronic tendon subluxation. Existing surgical techniques are limited by bulky subcutaneous repairs, reliance upon compromised tissues, and/or the need for postoperative immobilization. We describe a technically simple and repeatable extensor stabilization technique using a free tendon graft secured with the Arthrex SwiveLock Anchor. This novel approach is sutureless, low-profile, technically simple, and robust enough for immediate active motion. This technique was safely utilized in 8 patients by 3 different surgeons, with resolution of extensor instability without recurrence.