Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 25351
BILATERAL SIMULTANEOUS SPONTANEOUS HABITUAL ULNAR
DISLOCATION OF THE EXTENSOR DIGITORUM COMMUNIS TENDON OF LONG
FINGER: A CASE REPORT
Kuldeep MALIK 1 , Sudhir K KAPOOR 1 , Aashish CHAUDHRY 2
1 PGIMER, ESI Hospital, New Delhi (INDIA), 2 Sushruta Trauma Centre, New Delhi
(INDIA)
We report a case of a chronic bilateral simultaneous spontaneous habitual ulnar
dislocation of the extensor digitorum communis tendon of long fingers, its surgical
management and review of literature surrounding this disorder in a 22 year old
patient. His chief disability was the inability to difficulty in writing and thus was not
able to sit for his examinations O/E: Complete ulnar dislocation of the extensor
tendons of bilateral long finger was seen when the MP joint was flexed at 60 degrees
or more. Surgery: The superficial layer of the sagittal band covering the extensor
tendon was found to be ruptured just radial to the extensor tendon and also the
palmer part of the extensor tendon was detached from the deep layer of the sagittal
band. The soft tissue on radial side of the tendon was found to be grossly laxed. A
1.5 x 0.3 cm sling was fashioned from the laxed tissue and looped around the EDC
tendon and stitched on itself so as to act as a 'chekrein'. In addition to this, double
breasting of the remaining laxed tissue on radial side of tendon was done thus
increasing restraint to ulnar dislocation. Four weeks of postoperative immobilization
with a splint with the MP joint in a slightly flexed position was given. This was
followed by active and passive mobilization of the MP joint. At sixteen weeks after
surgery, patient had full range of motion without pain and the tendency for extensor
tendon dislocation had disappeared.
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