Anatomic Repair of the Central Slip with Anchor Suture Augmentation for Treatment of Established Boutonniere Deformity

A Central Slip Injury in a Professional Basketball Player

Hand injuries are extremely prevalent in sports such as ball sports. Delayed diagnosis or improperly managed injuries have the potential to prolong the athlete's return to the competition and permanently damage their abilities. We report the case of a 35-year-old male professional basketball player who presented to a chiropractor with pain and swelling of the right fifth finger two days after a basketball game. The injury occurred when a player passed the basketball and the ball hit his fifth finger "head-on". Examination revealed enlargement of the middle joint of the right fifth finger and a boutonniere deformity. He was diagnosed with a central slip injury using magnetic resonance imaging (MRI). Since there are no standard treatment guidelines for central slip injuries, multi-model chiropractic therapy was applied to the injury and adjacent sites. The patient returned to the game by the end of the third week and fully recovered within six weeks. Chiropractors must understand how to best guide athletes' clinical management of these injuries, given the inherent need for immediate and complete recovery.

Reconstruction of the central slip insertion of the extensor tendon with the partial slip of the flexor digitorum superficialis tendon

INTRODUCTION

To introduce the surgical approach and clinical effect of transferring the partial slips of the flexor digitorum superficialis (FDS) tendon to reconstruct the insertion of the central slip of the extensor tendon (CSET) through an established bone tunnel (BT).

MATERIALS AND METHODS

From April 2019 to March 2021, nine patients (six males and three females) with the CSET insertion rupture or defect were admitted to the institution and the CSET insertion was reconstructed with partial tendon slips on both sides of the FDS. The active range of motion of the interphalangeal joint of the affected finger was measured by a goniometer, the degree of pain was evaluated by visual analogue scale (VAS), and the grip strength of the affected limb was measured by an electronic hand dynamometer.

RESULTS

The average postoperative follow-up was 12 months. No complications occurred. At the last follow-up, six of the patients were very satisfied and three were satisfied with their recovery.

CONCLUSION

The reconstruction of the CSET insertion by transferring the partial tendon slips of the FDS seem to be safe and feasible with minimal invasion to the donor tendon.

TYPE OF STUDY/LEVEL OF EVIDENCE

Therapeutic IV.