Kronik Çekiç Parmak Cerrahisinde Tenodermodez Yönteminin Etkinliği

Abstract

Amaç: Mallet finger, distal interfalangeal (DIP) eklemin distalindeki ekstansör tendonun terminal insersiyonunun kısmen veya tamamen yırtılması nedeniyle yaygın olarak ortaya çıkan bir yaralanmadır. Genellikle DIP ekleminin zorlanmış fleksiyonundan kaynaklanır. Bu çalışmanın amacı Tenodermodez cerrahisinin kronik çekiç parmak yaralanmasındaki etkinliğini belirlemektir. Araçlar ve Yöntem: Toplam 15 hastanın verileri geriye dönük olarak incelendi. Konservatif tedavisi başarısız olan ve tenodermodez yöntemi ile çekiç parmak cerrahisi uygulanan tüm hastalar dahil edildi. Biz yöntemi modifiye ederek tendon ve kapsül sütürasyonu yapıldıktan sonra ayrıca cilt ve tendonu beraber kateden sütürasyon şeklinde uyguladık. Bulgular: Hastalar 24 aya kadar takip edildi. Tüm hastalarda DIP eklem hareketinde iyileşme vardı. Dokuz hasta DIP ekleminin tam ekstansiyonuna ulaştı. Crawford'un kriterlerine göre tüm hastalarda ‘ağrı yok’ ve işlem sonrası ‘mükemmel’ veya ‘iyi’ skoru elde edildi. Postop komplikasyon bildirilmedi. Sonuç: Tenodermodez yöntemi, kronik tendinöz çekiç parmak deformitesi için yüksek başarı sonuç oranına sahip küratif bir cerrahi tekniktir.

Keywords

• Mallet finger
• tenodermodez
• kronik yaralanma
• cerrahi

Efficacy of Tenodermodesis Method in Chronic Mallet Finger Surgery

Abstract

Purpose: Hammertoe is an injury that usually results from partial or complete rupture of the terminal insertion of the extensor tendon distal to the distal interphalangeal (DIP) joint. It is usually caused by forced bending of the DIP joint. The aim of this study is to determine the effectiveness of tenodermodesis surgery in chronic mallet finger injury. Materials and Methods: A total of 15 patients’ data was investigated retrospectively. All the patients whose conservative treatment failed and underwent a mallet finger surgery with the tenodermodesis method were included. The technic was slightly modified: Sutures were applied, so they traverse the skin and tendon together after suturing the tendon and capsule. Results: The patients were followed up for up to 24 months. All patients had improvements in DIP joint motion. Nine patients reached a full extension of the DIP joint. According to Crawford's criteria, all the patients had no pain and had excellent and good scores after the procedure. No postop complication was reported. Conclusion: Tenodermodesis method is a curative surgery technic with a high success outcome rate for chronic tendinous mallet finger deformity.

Keywords

• Mallet finger
• tenodermodesis
• chronic injury
• surgery

References

1. 1. Bendre AA, Hartigan BJ, Kalainov DM. Mallet finger. JAAOS-J Am Acad Orthop Surg. 2005;13(5):336-344.
2. 2. Zhang L, Zuo Y-M, Huo Y-X, Wang G-Q, Zhang L. Scar overlapping suture for treating chronic tendinous mallet finger in children. J. Orthop. Surg. Res. 2019;14(1):1-5.
3. 3. Lin JS, Samora JB. Surgical and nonsurgical management of mallet finger: a systematic review. J Hand Surg Am. 2018;43(2):146-163.
4. 4. Smit JM, Beets MR, Zeebregts CJ, Rood A, Welters CF. Treatment options for mallet finger: a review. Plast. Reconstr. Surg. 2010;126(5):1624-1629.
5. 5. Gurnani N, Hoogendoorn J, Rhemrev S. Mallet finger: surgery versus splinting. Ned. Tijdschr. Geneeskd. 2014;158:A6941-A6941.
6. 6. Shin EK, Bae DS. Tenodermodesis for chronic mallet finger deformities in children. Tech Hand Up Extrem Surg. 2007;11(4):262-265.
7. 7. Kardestuncer T, Bae DS, Waters PM. The results of tenodermodesis for severe chronic mallet finger deformity in children. J. Pediatr. Orthop. 2008;28(1):81-85.
8. 8. Sorene E, Goodwin D. Tenodermodesis for established mallet finger deformity. Scand J Plast Reconstr Surg Hand Surg. 2004;38(1):43-45.

9. 9. Makhlouf VM, Al Deek N. Surgical treatment of chronic mallet finger. Ann. Plast. Surg. 2011;66(6): 670-672.
10. 10. Alla SR, Deal ND, Dempsey IJ. Current concepts: mallet finger. Hand. 2014;9(2):138-144.