A simplified technique to correct hyperextension deformity of the metacarpophalangeal joint of the thumb.

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Abstract

A flexible hyperextension deformity of the metacarpophalangeal joint of the thumb in eleven patients was repaired by tendon reinforcement of the volar capsule of the joint using the tendon of the extensor pollicis brevis. This tendon, which was regarded as a deforming factor, was left attached at its insertion on the proximal phalanx and was divided at the musculotendinous junction proximally. The mobilized tendon was pulled out distally and then passed proximally and volarly, first superficial to the sheath of the long flexor tendon and then back through a hole in the neck of the metacarpal, and finally in a distal direction to form a criss-cross pattern and be sutured to the tendon of the adductor pollicis. The procedure gave reliable results after an average follow-up of 6.5 years in these eleven patients who had rheumatoid, paralytic, and traumatic lesions.

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