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American Association for Hand Surgery

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A New Technique of Pulley Creation for Additional Sagittal Band Reconstruction
Seong-Hwan Woo, M.D., Yeong-Seub Ahn, M.D., Ph.D. and Myung-Sun Kim, M.D., Ph.D., Chonnam National University Hospital, Gwangju, Korea, Republic of (South)

Because surgical treatments of chronic extensor tendon dislocation with sagittal band injury are complex and often require donor grafts, we suggest a new technique, pulley creation for additional sagittal band reconstruction. A 76-year-old man diagnosed with chronic extensor tendon dislocation with radial sagittal band injury was surgically treated by initially resecting the attenuated portion of the radial sagittal band and performing plication. Using the remnant tissue obtained after resection, additional sagittal band reconstruction was performed using two mini soft suture anchors in the form of a pulley surrounding the extensor tendon. The patient has shown satisfactory outcomes at 3 years follow-up. In conclusion, this study reports the pulley creation for additional sagittal band reconstruction combined with direct repair of the radial sagittal band as a novel surgical treatment for chronic extensor tendon dislocation. The technique is simple and concise, patient satisfaction with the outcome is high, and no donor site complications occur.


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