Terminal extensor tendon reconstruction as a reliable options for chronic mallet finger with swan neck deformity of index finger: A case report

INTRODUCTION: and importance: Chronic mallet finger resulted in mallet deformity or swan neck deformity are caused by imbalance of flexor and extensor mechanism. We tried to offer a reliable option of treatment by terminal tendon reconstruction using needle passer to exchange the use of K-wire which resulted in great result within 3 months of follow up. CASE PRESENTATION: 36 years old male with previous history of several trauma on his right arm and hand about three months ago; consists of distal phalangeal fracture of right index finger, right fifth metacarpal fracture, proximal phalanx fracture of right small finger, and right shaft radius fracture. After 3 months since initial injury, we focused on the right index finger which suffered in a swan neck deformity. The patient was unable to reach maximum flexion of his right index finger. We performed terminal extensor tendon reconstruction with great result after three months of follow up. CLINICAL DISCUSSION: Chronic mallet finger has many different techniques of surgical intervention, such as Fowler's tenotomy, tenodermodesis, spiral oblique retinacular ligament (ORL) reconstruction, and arthrodesis of distal interphalangeal (DIP) joint. The surgery was indicated after failure of 4 weeks finger splinting to correct the swan neck deformity. The aim of surgery was to improve finger function, restore normal active-passive flexion of proximal (PIP) and distal interphalangeal (DIP) joint by rebalancing the extensor mechanism of finger, relieve pain, and improve cosmetic appearance. CONCLUSION: Terminal extensor tendon reconstruction is a simple, reproducible and reliable option of surgical treatment in chronic mallet finger case. At minimum follow up of 3-months after surgery has showed a satisfactory result.