• Arch Orthop Trauma Surg · Apr 2024

    Dorsal capsule release and lateral band translocation for a stiff swan neck deformity without articular involvement.

    • JeromeJ Terrence JoseJTJ0000-0003-3321-9255Department of Orthopedics, Hand and Reconstructive Microsurgery, Olympia Hospital & Research Centre, 47, 47A Puthur High Road, Puthur, Trichy, Tamil Nadu, 620017, India. terrencejose@gmail.com..
    • Department of Orthopedics, Hand and Reconstructive Microsurgery, Olympia Hospital & Research Centre, 47, 47A Puthur High Road, Puthur, Trichy, Tamil Nadu, 620017, India. terrencejose@gmail.com.
    • Arch Orthop Trauma Surg. 2024 Apr 1; 144 (4): 185918631859-1863.

    BackgroundThe treatment for proximal interphalangeal joint (PIP) stiffness in extension requires extensor tenolysis, concomitant procedures to restore flexion, and intensive therapy. A stiff swan neck deformity without articular involvement is rare and the treatment is always challenging.MethodsSix patients with stiff swan neck deformities were operated between 2016 and 2023, and the outcome was analyzed retrospectively. A dorsal capsule release and radial lateral band translocation volar to the PIP joint axis were done. This translocation was maintained by a sling formed by the flexor digitorum superficialis and the free margins of the accessory collateral ligament. The range of movements in the PIP joint, visual analog scale (VAS), and functional outcomes were analyzed by the Michigan Hand Outcome Questionnaire (MHOQ) score.ResultsThe mean follow-up was 49.5 months (range 48-52 months). The mean preoperative PIP joint extension was 8 (range 5-10) degrees of extension), and the mean preoperative PIP joint flexion was 0. All patients improved after the surgery and the mean flexion of the PIP joint at follow-up was 95 degrees; extension was 1 degree (range 0-5 degrees). The mean Michigan Hand Outcomes Questionnaire (MHOQ) score was 92 (range 90-95) and the VAS was 0.ConclusionsDorsal capsule contracture release and lateral band translocation to the volar axis of the PIP joint seem to be the possibilities for correcting stiff swan neck deformity.Level Of EvidenceIV, retrospective case study.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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