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Correction of Swan Neck Deformity in Rheumatoid Arthritis Using a New Lateral Extensor Band Technique

From the Hand Surgery Department, St Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, Essex, UK

Correspondence: Mr D. Elliot, MA, FRCS, Consultant Hand and Plastic Surgeon, Hand Surgery Department, St Andrews Centre for Plastic Surgery, Broomfield Hospital, Court Road, Chelmsford, Essex CM1 7ET, UK. E-mail: info{at}david-elliot.co.uk.

Swan neck deformity is a progressive and disabling condition that commonly affects rheumatoid arthritic hands. During a 4-year period, 101 fingers in 43 patients had this deformity corrected using a new procedure combining the distally based extensor lateral band technique described by Littler and the flexor digitorum superficialis (FDS)-palmar plate pulley introduced by Zancolli. The ranges of motion of the metacarpophalangeal, proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints were assessed pre-operatively and 12 months after surgery. An average PIP joint hyperextension of –13.3° was converted to +13.4°. The ranges of motion of the proximal and DIP joints were significantly different (Student’s t-test). No patient suffered recurrence of the deformity during an average follow-up of 20 months. This new technique improves some unappealing aspects of previous techniques and provides a stable and reliable correction of swan neck deformity.

Key Words: swan neck deformity • rheumatoid arthritis • lateral extensor band • correction hand deformity • PIP joint hyperextension

This version was published on December 1, 2008

Journal of Hand Surgery (European Volume), Vol. 33, No. 6, 712-716 (2008)
DOI: 10.1177/1753193408092787


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