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Zancolli tendon transfer

This operation is generally done for a hyperextension deformity of the second knuckle joint of your finger. When the finger is viewed from the side it looks a little bit like a swan's neck. In your finger the joint might lock out and you have to bend it at that second knuckle in order to get it back. This can affect any digit. The disease is more common in rheumatoid arthritis. In order to do this procedure the joint has to be fairly mobile, thus when the finger is bent it should bend fairly freely towards 90 degrees.

ANAESTHETIC

General or regional anaesthetic.

OPERATIVE PROCEDURE

Procedures are generally done under local anaesthetic or general anaesthetic. The local anaesthetic is in the form of a block, which numbs the whole arm. An incision is made over the side of the finger. One of the two parallel lines at the top of your finger is then taken down to lie on the palmar side of your finger rather than lying on the back of your finger. A little pulley is made in order to keep it down on the front of the finger. The wound is sewn up and a finger stool dressing applied.

RESULTS

The operation is about 80% successful. The success really depends on the gravity of the joint disease rather that the ligament transfer itself.

COMPLICATIONS

  1. Scar tenderness. This can persist for six weeks post-operatively.
  2. Recurrence of the deformity. This can occur in 20% of cases.
  3. Finger stiffness.