ANTERIOR TENOARTHROLYSIS IN FLEXION DEFOR MITY OF THE FINGERS - A SERIES OF 41 CASES

Purpose of the study The ''hook finger'' with PIP and DIP flexion defo rmity, after multiple previous operations is difficult to treat. Class ical PIP arthrolysis combined with tenolysis are frequently unsuccessf ul. We studied the result of an operation of Total Anterior Teno-Arthr olysis (TATA) as described by Saffar in 1978. Materials and methods Am ong 41 patients with a mean age of 33 years, 73 per cent had at least one previous operation, on the flexor apparatus in the majority of cas es. Global PIP and DIP lack of extension was 131 degrees with a mean P IP lack of 80 degrees.The operation consists in ''en bloc'' lifting of the finger volar aspect including the two neuro-vascular bundles, the flexor apparatus and the two volar plate, by dissecting underneath th e periosteum of phalanges palmar aspect. The denuded distal squeleton is best covered by DIP arthrodesis combined with shortening. Results O nly one complication occurred with PIP septic arthritis. With a mean f ollow up of 7.6 years, four fingers were not improved, none was worsen ed and 37 were improved. Mean post-operative PIP extension lag was 30 degrees, giving a global (PIP and DIP) gain of 86 degrees. The PIP ARO M was only improved of 38 degrees. Conclusion The benefit of this salv age operation is mainly a change of the AROM in a more functional are. This has to be clearly explained to the patient and if accepted the s atisfaction is high (90 per cent in our series).