Classification and treatment of closed sagittal band injuries

Twenty-eight nonrheumatoid patients were treated for sagittal band injuries. The digits involved, in order of frequency, were long, small, index, and ring. We observed three clinical types of sagittal band injuries: type I, injury without extensor tendon instability; type II, injury with tendon subluxation; and type III, injury with tendon dislocation. Eight of nine patients with small finger involvement had radial sagittal band injuries; four of them presented with abduction deformity of the small finger. Satisfactory results were achieved with nonoperative treatment when it was initiated within 3 weeks of injury. Splinting was the initial treatment for all patients. Ten patients were treated either by centralization of the extensor tendon of the central two digits to provide pain-free stability or tendon transfer to correct small finger abduction deformity.