Volar Tenodesis for the Treatment of Swan-neck Deformity; A Systematic Review.

BACKGROUND

Swan-neck deformity is a common problem particularly in patients with Rheumatoid arthritis. Mobile swan-neck deformities (Nalebuff types I,II) can be treated non-operatively and operatively. In this paper we report on a systematic review of the treatment of swan-neck deformities with volar tenodesis.

METHODS

We performed a literature search and analysed the literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only eight papers were eligible. None was of high quality. The data reporting was very variable. Therefore, no meta-analysis could be performed, but only a descriptive analysis.

RESULTS

The techniques work in preventing proximal inter-phalangeal joint hyperextension between 60 and 100% in these studies. There appears to be some recurrence of hyper-extension with time so that papers with longer follow-up tend to have poorer results.

CONCLUSIONS

There is no good evidence that one technique is superior to another. The choice of technique is likely to remain based on surgeon preference for the foreseeable future. Future studies should be at least comparative and preferably part of a trial.