gms | German Medical Science

14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Reconstruction of the collateral ligament for old dislocation of the DIP joint

Meeting Abstract

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  • presenting/speaker Hiroyoshi Hagiwara - Tochigi Medical Center Shimotsuga, Tochigi, Japan
  • Yukinori Hayashi - Jichi Medical University, Shimotsuke, Japan
  • Kenji Kiyonaga - Ishibashi General Hospital, Shimotsuke, Japan
  • Tomoko Horii - Jichi Medical University, Shimotsuke, Japan
  • Suguru Hagiwara - Ishibashi General Hospital, Shimotsuke, Japan
  • Takashi Ajiki - Ishibashi General Hospital, Shimotsuke, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-561

doi: 10.3205/19ifssh0115, urn:nbn:de:0183-19ifssh01157

Veröffentlicht: 6. Februar 2020

© 2020 Hagiwara et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objectives/Interrogation: We report a case of old dislocation of the little finger. The reconstruction of the collateral ligament was performed with split FDP tendon.

Methods: A 74 year-old-woman was introduced to our institution who was suffering from the DIP joint pain of the right little finger. She fell off her bicycle when she was in junior high school and injured the finger. The injury was thought to be open dislocation of the DIP joint, but only treatment for the wound was conducted. She had felt the restriction of the range of motion and appearance of the deformity of the finger but only slight pain. At 6 years before the presentation, she had begun to feel acute pain at the joint. The pain had deteriorated gradually. Radiographs and computer tomography revealed approximately 70°ulnar deformity of the distal phalanx and dislocation of the DIP joint, which was accompanying osteoarthritic change. Active ROM of the little finger was MPJ 0°/90°, PIPJ 0°/60°, DIP-55°/90°. Q-DASH score was Disability 31.6/ Work 62.5/ Sport 0.

At 3 weeks from the present day, surgical procedure was performed. The collateral ligament of the radial side at the DIP joint was not recognized. 1/3 FDP of the ulnar side was cut at the A3 pulley level and split to the distal phalangeal base, then it was turned over and A5 pulley was incised. A 2.3mm transverse burr hole was made at the condyle of the middle phalanx and passed the split FDP through the hole from ulnar side to the radial side. With applying tension, it was sutured to the soft tissue on the distal phalangeal base at the radial side after reduction of the DIP joint. ROM exercise of the DIP joint was begun from 4 weeks.

Results and Conclusions: At 1 year from surgery, slight ulnar deformity of the distal phalanx was recognized. Active ROM of the finger was MPJ30°/90°, PIPJ0°/90°, DIPJ0°/30°. Q-DASH score was Disability 4.5/ Work 0/ Sport 0.

Favorable clinical outcome was obtained.