Oblique retinacular ligament reconstruction for chronic mallet finger deformity

Surgical correction of chronic mallet finger caused by terminal tendon disruption was carried out in 12 patients with passively correctable deformities. The oblique retinacular ligament (ORL) was reconstructed with the palmaris longus used as a free tendon graft. The graft was fixed to the terminal extensor tendon by soft tissue technique only. It was then routed obliquely across the palmar aspect of the proximal interphalangeal (PIP) joint and sutured to the fibroosseous rim of the flexor sheath. In all cases, the mallet finger deformity was corrected. Secondary PIP hyperextension, present in eight of the 12 patients, was also corrected by this technique. Subsequent surgical procedures were necessary in two patients: one required a limited flexor tenolysis in the digit, thereby obtaining a full range of motion; the second required lengthening of the ORL graft to obtain full PIP joint extension. All patients were pleased with the results. Reconstruction of the ORL is an advantageous procedure in certain patients with chronic mallet finger deformities. This technique is easily performed and yields consistently good results.