Abstract
We aimed to introduce a surgical option for crushing–penetrating injuries around the metacarpophalangeal (MP) joint of the middle finger with extensor reconstruction of the interphalangeal (IP) joints. We also assessed the outcomes of patients using this surgical protocol. First, MP joint reconstruction was performed early (mean, 1.2 weeks after injury) using free autogenous cartilage or bone graft. We next performed a tendon transfer using a modified Brand method (M. Brand) at the same setting of extensor tendon tenolysis (mean, 4.7 months after injury) in order to extend the IP joints as a bonus for mutilating injuries of the hand. The mean arc of motion of each MP and IP joint increased after the M. Brand procedure. In one patient, worsening of palmar subluxation at the base of the proximal phalanx at the MP joint was observed. We found that tendon transfer by M. Brand achieves additional reconstruction for patients who have an IP joint extension lag after a crushing–penetrating injury around the MP joint. On the basis of these encouraging findings in this small series of cases, we recommend the M. Brand procedure after the MP joint stabilizes, as an optional bonus for mutilating injured hand.
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Conflict of Interests
No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study. All named authors (Yoshitaka Hamada, MD; Naohito Hibino, MD) hereby declare that they have no conflicts of interests of interest to disclose.
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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation 140 (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).
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Identifying information, including patients' names, initials, or hospital numbers, were not published in written descriptions, photographs, and pedigrees.
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Hamada, Y., Hibino, N. The treatment of extensor lag of the middle finger following crushing–penetrating injuries of the metacarpophalangeal joint: case series. HAND 9, 534–538 (2014). https://doi.org/10.1007/s11552-013-9573-y
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DOI: https://doi.org/10.1007/s11552-013-9573-y