PMC10326519_01
Ulnar side sagittal band dislocation of both third and fourth fingers.
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F1
With grasping, bilateral subluxation of extensor tendons of the third and fourth fingers on the metacarpal heads toward the ulnar side were observed (Figure 1).
(A,B) Sagittal band reconstruction using tendon slip of the right third EDC using the Elson technique. The dotted line and arrow indicate the direction in which radial-side tendon slip of the third EDC passes under the deep transverse intermetacarpal ligament, forms a lateral loop, and returns to the third EDC tendon. The solid line indicates the deep transverse intermetacarpal ligament. (C) Disappeared sagittal band dislocation of right fourth finger after reconstruction of third sagittal band. EDC, extensor digitorum communis.
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F2
The third sagittal band reconstruction was performed using the Elson technique (Figures 2A,B). After reconstruction of the right third sagittal band, we observed that the dislocation of the extensor tendon of the fourth finger was corrected spontaneously (Figure 2C).
(A) A temporary radial-side dislocation of the right fifth extensor tendon after sagittal band reconstruction of the third finger. (B) Soft tissue adhesion on reconstruction site on the left third finger and no reconstruction of the fourth sagittal band.
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F3
After 1 week from the operation, we observed a new radial-side dislocation of the extensor tendon of the right fifth finger (Figure 3A). After the procedure on the third finger, the extensor tendon dislocation on the fourth finger was resolved spontaneously; hence, we could finish the surgery only with adhesiolysis without reconstruction of the fourth sagittal band (Figure 3B).
No recurrence of sagittal band dislocation and no pain after 18 months from operation.
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F4
No recurrence of the extensor tendon dislocation or pain occurred in the MCP joint until 18 months post-surgery (Figure 4).