Background: Sawn neck deformities of the fingers are
challenging and difficult for treatment. Many techniques had
been used with different success rates depending on the cause
of deformity and the technique used for correction. Techniques
deal with either lateral band mobilization or oblique retinacular
ligament reconstruction (ORL) popularly used with many
refinements.
Objectives: To evaluate which surgical maneuver is better
for correction of swan neck deformity and to compare results
of lateral band mobilization and oblique retincular ligament
reconstruction.
Patients and Method: 11 patients suffered from swan
neck deformities. 24 fingers after rheumatoid arthritis, 5
post-burn and 3 post-traumatic. Divided into 2 groups, 20
fingers were corrected by lateral band mobilization (Group < br />A). 12 fingers underwent ORL reconstruction (Group B).
Assessment was done by measurement of extension lag on
DIP by goniometer after 6 months compared with that done
pre-operatively.
Results: DIP extension lag improved with lateral band
mobilization especially non-rheumatoid patients. But with
ORL reconstruction the results were not satisfactorty as regard
as entension lag and PIP hyperentension.
Conclusion: Lateral band mobilization is a reliable method
for correction of swan neeck deformity especially with nonrheumatoid
patients (burn and trauma), but long-term results
of lateral band translocation in rheumatoid patients are disappointing,
as regard as ORL reconstruction with tendon graft,
it did not show satisfactory results in this study.