Abstract
We report eleven cases of chronic, non-fixed, post-traumatic boutonnière deformity treated by the technique of Pieper: One lateral slip was mobilised and distally desinserted. At the PIP, the slip was pulled through the central slip and sutured in correct tension to the released opposite lateral slip. 73 % regained full extension at the proximal interphalangeal joint. Despite a mild extension deficit of 15° at the distal interphalangeal joint in 64 %, ten of eleven patients were content with the post-operative outcome.
We conclude that the technique of Pieper is a good and valuable operative procedure to correct chronic non-fixated button-hole deformity.
Key words
Finger deformity - boutonnière deformity - button-hole deformity - operative technique
Literatur
-
1
Caroli A, Zanasi S, Squarzina M, Guerra M, Pancaldi G.
Operative treatment of the post-traumatic boutonnière deformity.
J Hand Surg [Br].
1990;
15
410-415
-
2
Burkhalter W E, Carneiro R S.
Correction of the attritional boutonnière deformity in high ulnar-nerve paralysis.
J Bone Joint Surg [Am].
1979;
61
131-134
-
3
Dolphin J A.
Extensor tenotomy for chronic boutonnière deformity of the finger. Report of two cases.
J Bone Joint Surg [Am].
1965;
47
161-164
-
4 Fowler S B. Zit. nach Wilhelm, A.: Rekonstruktionsoperation durch Sehnentransplantation. Nigst H, Buck-Gramcko D, Millesi H Handchirurgie. Band II. Stuttgart, New York; Thieme 1983: 38.21-38.33
-
5
Gama C.
Results of the Matev operation for correction of Boutonnière deformity.
Plast Reconstr Surg.
1979;
64
319-324
-
6 Kaplan E B. Zit. nach Wilhelm, A.: Operationsmethoden zur Reinsertion und Raffung des Tractus Intermedius. Nigst H, Buck-Gramcko D, Millesi H Handchirurgie. Band II. Stuttgart, New York; Thieme 1983: 38.16
-
7
Littler J W, Eaton R G.
Redistribution of forces in the correction of the boutonnière deformity.
J Bone Joint Surg [Am].
1967;
49
1267-1274
-
8
Matev I.
Transposition of the lateral slips of the aponeurosis in treatment of long-standing “boutonnière deformity” of the fingers.
Brit J Plast Surg.
1964;
17
281-286
-
9 Nichols H M. Zit. nach Wilhelm, A.: Rekonstruktionsoperation durch Sehnentransplantation. Nigst H, Buck-Gramcko D, Millesi H Handchirurgie. Band II. Stuttgart, New York; Thieme 1983: 38.21-38.33
-
10 Nigst H, Buck-Gramcko D, Millesi H. (Hrsg) .Handchirurgie. Band II. Stuttgart, New York; Thieme 1983: 38.13-38.23
-
11
Ohshio I, Ogino T, Minami A, Kato H.
Reconstruction of the central slip by the transverse retinacular ligament for boutonnière deformity.
J Hand Surg [Br].
1990;
15
407-409
-
12 Pieper W. Diskussionsbemerkung, Handchirurgisches Symposium. Erlangen; 1966
-
13
Rothwell A G.
Repair of the established posttraumatic boutonnière deformity.
The Hand.
1978;
10
241-245
-
14
Souter W A.
The boutonnière deformity. A review of 101 patients with division of the central slip of the extensor expansion of the fingers.
J Bone Joint Surg [Br].
1967;
49
710-721
-
15 Tubiana R. Lésions des tendons extenseurs. Tubiana R Chirurgie de la main. Paris; Masson 1986: 141-142
-
16 Verdan C E. Zit. nach Wilhelm, A.: Operationsmethoden zur Reinsertion und Raffung des Tractus intermedius. Nigst H, Buck-Gramcko D, Millesi H Handchirurgie. Band II. Stuttgart, New York; Thieme 1983: 38.16
-
17
Weeks P M.
The chronic boutonnière deformity: A method of repair.
Plast Reconstr Surg.
1967;
40
248-251
-
18 Wilhelm A. Wiederherstellungschirurgie der Strecksehnen. Nigst H, Buck-Gramcko D, Millesi H Handchirurgie. Band II. Stuttgart, New York; Thieme 1983: 38.1-38.33
-
19
Wilhelm A, Wilhelm F.
Die Behandlung des Knopflochphänomens und ähnlicher Funktionsausfälle.
Handchirurgie.
1980;
12
177-184
-
20
Wintsch K, Oesch A.
Operation nach Pieper bei der Knopflochdeformität.
Helv Chir Acta.
1976;
43
143-145
Dr. med. D. Th. Stäuble
Unité de Chirurgie de la Main, HUG-Hôpital Cantonal
1211 Genève 14
Schweiz
Email: danielstaeuble@hotmail.com
