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• W3155581278 abstract "Purpose The spiral oblique retinacular ligament (SORL) procedure acts as a dynamic tenodesis to restore distal interphalangeal joint (DIP) extension and restrain proximal interphalangeal hyperextension. Despite the ingenious technique based on the oblique retinacular ligament anatomy, obtaining strong internal fixation remains an issue during the SORL procedure. We present a modified technique using the flexor digitorum profundus (FDP) hemi-tendon transfer. Methods We dissected 5 fresh cadaveric specimens to evaluate morphometric parameters of the SORL procedure using the hemi-FDP. The volar groove of the FDP tendon was identified in zone I of the flexor sheath and the tendon was divided into radial and ulnar bundles. The selected hemi-tendon was divided at the proximal edge of the A1 pulley and a SORL procedure was performed through a transosseous tunnel in the distal phalanx. This technique was used in 3 patients with swan neck deformity. Results The optimal distance between the DIP joint and the anterior drill hole of the transosseous tunnel was 7.6 mm (range, 6.8–8.5 mm). The relative loss of length of the tendon owing to the SORL path was 25.8 mm (range, 19.6–29.9 mm). In the clinical cases, the procedure improved DIP joint extension lag and prevented proximal interphalangeal joint hyperextension. Preserving one-half of the FDP allowed complete flexion of the DIP joint. Conclusions The procedure is technically feasible. Its main advantages are that a distal suture is not required and that the substantial length of the tendon allows sturdy proximal internal fixation. Type of study/level of evidence Therapeutic V. The spiral oblique retinacular ligament (SORL) procedure acts as a dynamic tenodesis to restore distal interphalangeal joint (DIP) extension and restrain proximal interphalangeal hyperextension. Despite the ingenious technique based on the oblique retinacular ligament anatomy, obtaining strong internal fixation remains an issue during the SORL procedure. We present a modified technique using the flexor digitorum profundus (FDP) hemi-tendon transfer. We dissected 5 fresh cadaveric specimens to evaluate morphometric parameters of the SORL procedure using the hemi-FDP. The volar groove of the FDP tendon was identified in zone I of the flexor sheath and the tendon was divided into radial and ulnar bundles. The selected hemi-tendon was divided at the proximal edge of the A1 pulley and a SORL procedure was performed through a transosseous tunnel in the distal phalanx. This technique was used in 3 patients with swan neck deformity. The optimal distance between the DIP joint and the anterior drill hole of the transosseous tunnel was 7.6 mm (range, 6.8–8.5 mm). The relative loss of length of the tendon owing to the SORL path was 25.8 mm (range, 19.6–29.9 mm). In the clinical cases, the procedure improved DIP joint extension lag and prevented proximal interphalangeal joint hyperextension. Preserving one-half of the FDP allowed complete flexion of the DIP joint. The procedure is technically feasible. Its main advantages are that a distal suture is not required and that the substantial length of the tendon allows sturdy proximal internal fixation." @default.
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• W3155581278 date "2021-04-01" @default.
• W3155581278 modified "2023-09-23" @default.
• W3155581278 title "Spiral Oblique Retinacular Ligament Procedure Using Flexor Digitorum Profundus Hemi-Tendon Transfer: Anatomical Basis and Clinical Application" @default.
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• W3155581278 doi "https://doi.org/10.1016/j.jhsa.2021.02.018" @default.
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