Fowler Central Slip Tenotomy or Spiral Oblique Retinacular Ligament Reconstruction? A Cadaveric Biomechanical Study in Swan-Neck Deformity. (September 2020)

• Record Type: Journal Article
• Authors: Deml, Christian; Baradaran, Aslan; Chen, Neal; Nasr, Michael; Kachooei, Amir R.
• Is Part Of: Hand. Volume 15:Number 5(2020)
• Page Start: 620
• Page End: 624
• Publication Date: 2020-09
• Subjects: cadaveric biomechanical study -- Fowler central slip tenotomy -- spiral oblique retinacular ligament reconstruction -- swan-neck deformity; Hand -- Surgery -- Periodicals; Hand -- Surgery; Periodicals; 617.57005
• DOI: 10.1177/1558944719834643
• Languages: English
• ISSNs: 1558-9447

Abstract

Background: The goal of this study is to biomechanically compare Fowler central slip tenotomy with spiral oblique retinacular ligament (SORL) reconstruction in correcting a chronic mallet deformity as part of a swan-neck deformity.Methods: We used 24 human cadaver fingers from 6 hands. Mallet finger and swan-neck deformities were created; then, Fowler tenotomy was done on one group including 3 hands with 12 fingers, and SORL reconstruction was done on the others.Results: During simulated finger extension, there was no significant difference between the 2 techniques in correcting the distal interphalangeal joint droop; however, Fowler tenotomy resulted in hyperflexion of the proximal interphalangeal (PIP) joint, whereas it remained straight after SORL reconstruction.Conclusions: This study supports the SORL reconstruction in correcting a chronic mallet deformity, especially when there is a concomitant PIP hyperextension deformity, which lowers the risk of reversing the deformity after a Fowler procedure.