• M F Langer, B Wieskötter, R Hartensuer, C Kösters, and S Oeckenpöhler.
• Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Waldeyerstr. 1, 48149, Münster, Deutschland. langer.martin@ukmuenster.de.
• Oper Orthop Traumatol. 2015 Oct 1; 27 (5): 394-403.

ObjectiveStabile recentering the extensor tendon over the top of the head of the metacarpal to restore the exact tension and the direction.IndicationsDislocation of the extensor tendon at the metacarpophalangeal (MP) joint with functional disabilities of the fingers.ContraindicationsSevere osteoarthritis of the MP joint. Accompanying injuries of collateral ligaments. Fibrosis of the MP joint or contractures of the intrinsic muscles.Surgical TechniqueCurved 8 cm skin incision at distal metacarpal, MP joint, and proximal phalanx. A distally pedicled central tendon strip from the extensor digitorum communis (EDC) tendon is removed. Centralization of the tendon by reconstructing the sagittal ligament and the proximal part of the extensor hood. The tendon strip is wrapped around the tendon of the interossous muscle.Postoperative ManagementImmobilization of the MP joint in 30° flexion with free proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints for 4 weeks. Full fist after 5 weeks.ResultsIn all 16 patients good or very good results were achieved. There were no recurrences of tendon dislocations, no MP joint contractures, and only a few minor extensor tendon adhesions.

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