Article

The extensor tendon splitting approach to the proximal interphalangeal joint: do we need to reinsert the central slip?

Department of Orthopaedics and Rehabilitation, University of New Mexico, New Mexico, USA.
The Journal of hand surgery, European volume 12/2009; 35(3):188-91. DOI:10.1177/1753193409352411 pp.188-91
Source: PubMed

ABSTRACT Current approaches to the proximal interphalangeal (PIP) joint have potential complications and limitations. We present a dorsal approach that involves splitting the extensor tendon in the midline, detaching the insertion of the central slip and repairing the extensor tendon without reinserting the tendon into the base of the middle phalanx. A retrospective review of 16 digits that had the approach for a PIP joint arthroplasty with a mean follow up of 23 months found a postoperative PIP active ROM of 61 degrees (range 25-90 degrees). Fourteen digits had no extensor lag, while two digits had an extensor lag of 20 degrees and 25 degrees. This modified approach is fast and simple and does not cause an extensor lag.

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Keywords

16 digits
 
23 months
 
61 degrees
 
Current approaches
 
extensor
 
extensor tendon
 
limitations
 
middle phalanx
 
modified approach
 
PIP
 
PIP joint arthroplasty
 
postoperative PIP active ROM
 
range 25-90 degrees
 
reinserting
 
retrospective review
 
tendon