Swan Neck Deformity following Excision of FDS
- Discussion:
- may result from complete excision of the flexor digitorum sublimis;
- it is especially likely to occur in patients with a hyperextensible PIP joint;
- major vinculum exists at the insertion of the sublimis tendon;
- when tendon is exised to to its insertion, the vinculum is violated, creating major source of adhesion formation for reconstructed tendon;
- check rein effect on the joint is lost, allowing hyperextension;
- this creates a relative lengthening of the extensor apparatus, causing terminal phalanx to drop into flexion;
- lateral bands displace dorsally;
- Prevention:
- do not excise sublimis distally farther than neck of middle phalanx or just proximal to vinculum;
- if possible, the remaining sublimis should be left even longer
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Data Trace Staff on Thursday, December 15, 2011 10:51 am
