Extractable suture traction combined with K-wire fixation for the treatment of rupture of the insertion point of flexor and extensor tendons of the distal phalanx of the finger

Wang Song; Tao Zhongsheng; Geng Li; Chen Jinqiang; Zhao Ning; Wang Qiang; Zhu Yuexin; Li Changyun

doi:10.3969/j.issn.1009-4237.2025.03.009

Abstract：Objective To explore the clinical efficacy of extractable suture traction combined with K-wire fixation in the treatment of rupture of the insertion point of the flexor and extensor tendons of the distal phalanx of the finger.Methods A retrospective analysis was conducted on the data of 30 cases with traumatic rupture of the in-sertion point of the flexor and extensor tendons of the distal phalanx admitted to Baoding Sixth People's Hospital from Mar.2018 to Dec.2023,including 21 males and 9 females.The age ranged from 3 to 60 years,with an aver-age of 31.6 years.There were 11 cases of sports impact injuries,4 collision injuries,3 machine crush injuries,7 sprain injuries,and 5 cutting injuries.All patients were treated with open surgery.A K-wire was used to fix the dis-tal interphalangeal joint in hyperextension or flexion position percutaneously from the fingertip.A hook was made at the distal end of the wire tail.The tendon suture was used to repair and suture the tendon stump,and then to tract the tendon stump to penetrate the skin and finally be knotted and fixed on the hook of the K-wire.The K-wire and suture were removed 6 weeks after surgery,and progressive exercise was started.After surgery,the presence of nail deformity was observed,and the degree of wound scar irritation by the suture knot was evaluated.The range of mo-tion of the distal interphalangeal joint was evaluated using the total active motion(TAM)recommended by the In-ternational Society of Hand Surgery.Results All the cases were followed up for 3 to 60 months,with an average of 8.6 months.There was no wound infection or skin edge necrosis.Mild groove-shaped nail deformity occurred in 1 case;another case presented obvious hematoma after surgery,which was removed with compression bandage and healed after dressing change.The dorsal finger wounds of 2 cases were ulcerated due to irritation by the tendon su-ture knots,which also healed after removal of the suture knots and dressing change.Based on the TAM,there were 15 excellent cases,11 good,3 fair,and 1 poor,with an excellent-good rate of 86.6%.Conclusion Using extract-able suture traction combined with K-wire fixation in the treatment of rupture of the insertion point of the flexor and extensor tendons of the distal phalanx of the finger can provide continuous elastic traction on the tendon stumps to enable the tendon stumps to heal without tension.This method is simple,with few complications but satisfactory clin-ical outcomes.