What is Fowler tenotomy?
The Fowler tenotomy, adjusting the balance of the extensor mechanism by central slip and lateral band detachment, is a common surgical technique for chronic mallet finger.
What is the difference between tenotomy and tenodesis?
Tenotomy is a simple procedure, but it may produce visible deformity, subjective cramping, or loss of supination strength. Tenodesis is a comparatively technical procedure involving a longer recovery, but it has been hypothesized to achieve better outcomes in younger active patients (<55 years).
What is Retinacular ligament?
A retinaculum is a fibrous band that acts to stabilize a tendon. Located in the finger, the oblique retinacular ligament (ORL) is believed to aid in stabilization of the proximal interphalangeal (PIP) joint.
Can a tenotomy be reversed?
The loop cannot come undone because the end of the LHB tendon is wider than the hole in the tendon. Given the diameter of the loop, the tendon will remain in its position at the entrance to the bicipital groove.
What does the retinaculum do?
A retinaculum (plural retinacula) is a band of thickened deep fascia around tendons that holds them in place. Its function is mostly to stabilize a tendon. The term retinaculum is New Latin, derived from the Latin verb retinere (to retain).
What is extensor hood?
The extensor hoods are triangular aponeuroses by which the extensor tendons insert onto the phalanges. Contraction of the extensor digitorum muscle tightens this tendon which acts on these attachments and extends the fingers.
What is Fowler tenotomy for mallet finger?
The Fowler tenotomy, adjusting the balance of the extensor mechanism by central slip and lateral band detachment, is a common surgical technique for chronic mallet finger.
How do you reduce extensor lag in Fowler tenotomy?
In the Fowler tenotomy models, detachment of the central slip and lateral band from the middle phalanx reduced extensor lag of the DIP joint. Detachment of up to two-thirds of the phalangeal length was effective in this model and did not cause any boutonniere deformity.
Can central slip tenotomy be combined with distal tenotomy for finger deformities?
The author is unaware of any studies that combine central slip tenotomy with a distal repair, using small transverse incisions at the PIP and DIP, respectively, to repair chronic omllet fingers, whose deformities exceed 360. This article describes the technique in detail, as well as its indications, postoperative man- agement, and complications.
What does the terminal extensor tendon do?
SURGICAL ANATOMY AND KINETICS The terminal extensor tendon is a flat, thin structure measuring on average 1.1 mm; it inserts onto the distal phalanx up to 1.2 mm distal to the joint margin and 1.4 mm proximal to the germinal nail matrix. The terminal extensor tendon adheres to the underlying dorsal aspect of the DIP joint capsule.
