Reconstruction of extensor apparatus insertion using crisscross tunneling and double loop suture

Objective To introduce a method of extensor apparatus insertion reconstruction.Methods The distal interphalangeal joint was fixed by a Kirschner wire.Two loop sutures were placed on both sides of the distal end of the extensor tendon and passed through a transverse tunnel at the base of the distal phalanx in a crisscross fashion.One end of the loop suture was reflected proximally to weave through the extenser tendon and tied on the axis of the tendon.Another end of the loop suture was directly tied against the dorsum of the tendon.This technique was applied in 39 cases of mallet fingers due to extensor tendon insertion rupture.Results All the cases were followed for 5 months to 2 years.There was no tendon rupture and tendon adhesion.Range of motion of the distal interphalangeal joint was 0°-70°in 18 cases,0°-60° in 17 cases,and 0°-50° in 4 cases.According to TAM evaluation criteria,the results were rated as excellent in 25 cases and good in 14 cases.The overall satisfactory rate was 100%.Conclsion Crisscross tunneling and double loop suture is an easy and effective way to reconstruct extensor apparatus insertion. Key words: Tendon injuries; Surgical procedures,operative; Mallet fingers