Abstract

FERREYRA, Andrés et al. Tenodermodesis para el tratamiento del dedo en martillo tendinoso de presentación tardía en niños y adolescentes. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2021, vol.86, n.1, pp.23-30. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2021.86.1.1006.

Introduction: Diagnosis of soft tissue mallet finger may go unnoticed initially in children and adolescents, limiting the possibili-ties of conservative treatment. The aim of this study was to evaluate the results of surgical treatment with the tenodermodesis technique in late-presentig lesions. Materials and Methods: Nine patients (8 male) with an average age 8.6±6 years (range 1-15 years) were retrospectively evaluated. The lesion presented at an average of 27±11.4 days after trauma (range 15 to 45 days). In 4 patients the mechanism was a laceration and in 5 indirect trauma. Patients were treated by tenodermodesis and transitory fixa-tion of the distal interphalangeal joint with a Kirshner-wire. The average follow-up was 61±34.7 months (range 12-106 months). Active and passive mobility of the distal interphalangeal joint (DIPJ), pain, deformity, limitation of activities of daily life, and need for further treatment were evaluated. Crawford criteria was used to evaluate the outcomes. Results: The results were excellent in eight patients, and fair in one according to the Crawford criteria. One case required reoperation for re-rupture in a poorly collabo-rating patient. Two cases presented as a complication a granuloma and required resection of it. No patient presented pain at the last follow-up, nor limitations for activities of daily living. Eight patients had full active DIPJ extension, and one had a 20° residual deformity. Conclusion: Tenodermodesis allows anatomical reconstruction of the extensor mechanism in pediatric patients. The clinical results are encouraging in late-presenting lesions.

Keywords : Mallet finger; tenodermodesis; late presentation; pediatric.

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