Log in

Reconstruction of the central slip insertion of the extensor tendon with the partial slip of the flexor digitorum superficialis tendon

  • Handsurgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

To introduce the surgical approach and clinical effect of transferring the partial slips of the flexor digitorum superficialis (FDS) tendon to reconstruct the insertion of the central slip of the extensor tendon (CSET) through an established bone tunnel (BT).

Materials and methods

From April 2019 to March 2021, nine patients (six males and three females) with the CSET insertion rupture or defect were admitted to the institution and the CSET insertion was reconstructed with partial tendon slips on both sides of the FDS. The active range of motion of the interphalangeal joint of the affected finger was measured by a goniometer, the degree of pain was evaluated by visual analogue scale (VAS), and the grip strength of the affected limb was measured by an electronic hand dynamometer.

Results

The average postoperative follow-up was 12 months. No complications occurred. At the last follow-up, six of the patients were very satisfied and three were satisfied with their recovery.

Conclusion

The reconstruction of the CSET insertion by transferring the partial tendon slips of the FDS seem to be safe and feasible with minimal invasion to the donor tendon.

Type of study/level of evidence

Therapeutic IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ahmad F, Pickford M (2009) Reconstruction of the extensor central slip using a distally based flexor digitorum superficialis slip. J Hand Surg Am 34(5):930–932

    Article  Google Scholar 

  2. Bellemere P (2015) Treatment of chronic extensor tendons lesions of the fingers. Chir Main 34(4):155–181

    Article  CAS  Google Scholar 

  3. Dinc U, Sengezer E, Beger O, Yilmaz MS, Kurtoglu Olgunus Z (2021) Morphological features of the chiasma tendinum and its relation with surface landmarks and pulleys: a cadaveric study. Surg Radiol Anat 43(10):1623–1633

    Article  Google Scholar 

  4. Dubois E, Teboul F, Bihel T, Goubier JN (2017) Chronic boutonniere deformities, supple, or stiff: a new surgical technique with early mobilization in 11 cases. Tech Hand Up Extrem Surg 21(2):37–40

    Article  Google Scholar 

  5. Duzgun S, Duran A, Keskin E, Yigit AK, Buyukdogan H (2017) Chronic boutonniere deformity: cross-lateral band technique using palmaris longus autograft. J Hand Surg Am 42(8):661e661-661e665

    Article  Google Scholar 

  6. Elzinga K, Chung KC (2019) Managing Swan neck and boutonniere deformities. Clin Plast Surg 46(3):329–337

    Article  Google Scholar 

  7. Geoghegan L, Wormald JCR, Adami RZ, Rodrigues JN (2019) Central slip extensor tendon injuries: a systematic review of treatments. J Hand Surg Eur 44(8):825–832

    Article  Google Scholar 

  8. Gonzalez MH, Nikoleit J, Weinzweig N (1998) The chiasma of the flexor digitorum superficialis tendon. J Hand Surg Br 23(2):234–236

    Article  CAS  Google Scholar 

  9. Gordon JA, Stone L, Gordon L (2012) Surface markers for locating the pulleys and flexor tendon anatomy in the palm and fingers with reference to minimally invasive incisions. J Hand Surg Am 37(5):913–918

    Article  Google Scholar 

  10. Ijpma FF, van de Graaf RC, van Gulik TM (2010) Petrus Camper’s work on the anatomy and pathology of the arm and hand in the 18th century. J Hand Surg Am 35(8):1382–1387

    Article  Google Scholar 

  11. Jerome TJ (2021) Flexor Digitorum Superficialis tendon transfer for a long-standing boutonniere deformity finger - a retrospective study of 11 cases. Orthop Traumatol Surg Res 107(5):553

    Article  Google Scholar 

  12. Lee JK, Lee S, Kim M, Jo S, Cho JW, Han SH (2021) Anatomic repair of the central slip with anchor suture augmentation for treatment of established boutonniere deformity. Clin Orthop Surg 13(2):243–251

    Article  Google Scholar 

  13. Li Y, Ding A, He Z, Xue F (2014) Comparison of proximal turndown of central slip combined with suture of lateral bands versus free tendon grafting for central slip reconstruction after an open finger injury. Acta Orthop Belg 80(1):119–125

    Google Scholar 

  14. Liu YJ, Ding XH, Ji X, Jiao HS, Ren SQ, Zhang HX (2021) Y-Shaped tendon graft-A technique in the reconstruction of posttraumatic chronic boutonniere deformity. J Hand Surg Am 46(8):712.e711–712.e716

    Article  Google Scholar 

  15. Lui P, Zhang P, Chan K, Qin L (2010) Biology and augmentation of tendon-bone insertion repair. J Orthop Surg Res 5:59

    Article  Google Scholar 

  16. McKeon KE, Lee DH (2015) Posttraumatic boutonnière and swan neck deformities. J Am Acad Orthop Surg 23(10):623–632

    Article  Google Scholar 

  17. Patel SS, Singh N, Clark C, Stone J, Nydick J (2018) Reconstruction of traumatic central slip injuries: technique using a slip of flexor digitorum superficialis. Tech Hand Up Extrem Surg 22(4):150–155

    Article  Google Scholar 

  18. Snow JW (1973) Use of a retrograde tendon flap in repairing a severed extensor in the pip joint area. Plast Reconstr Surg 51(5):555–558

    Article  CAS  Google Scholar 

  19. Snow JW (1976) A method for reconstruction of the central slip of the extensor tendon of a finger. Plast Reconstr Surg 57(4):455–459

    Article  CAS  Google Scholar 

  20. Soldado F, De la Red- Gallego MA, Barrera-Ochoa S (2020) Dynamic transfer with the flexor digitorum superficialis for chronic boutonnière deformity reconstruction: a report of two cases. J Hand Surg (European Volume) 45(4):415–417

    Article  Google Scholar 

  21. Walbeehm ET, McGrouther DA (1995) An anatomical study of the mechanical interactions of flexor digitorum superficialis and profundus and the flexor tendon sheath in zone 2. J Hand Surg Br 20(3):269–280

    Article  CAS  Google Scholar 

  22. Zafonte B, Rendulic D, Szabo RM (2014) Flexor pulley system: anatomy, injury, and management. J Hand Surg Am 39(12):2525–2532 (quiz 2533)

    Article  Google Scholar 

Download references

Funding

There is no funding source.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jihui Ju.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, H., Zhang, Y., Li, R. et al. Reconstruction of the central slip insertion of the extensor tendon with the partial slip of the flexor digitorum superficialis tendon. Arch Orthop Trauma Surg 143, 539–544 (2023). https://doi.org/10.1007/s00402-022-04443-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-022-04443-z

Keywords

Navigation