Comparison of proximal turndown of central slip combined with suture of lateral bands versus free tendon grafting for central slip reconstruction after an open finger injury.

We randomized patients with open finger injury and central slip insertion defects into a proximal turn-down group (final n = 28) and a palmaris longus tendon graft group (final n = 20). In the proximal turn-down group, the dorsal central slip of the extensor tendon in the proximal phalanx was split, leaving it attached distally. We turned the strip from proximal to distal and fixed it using the distal joint capsule of the proximal interphalangeal joint as the distal insertion of reconstruction, and the extended central slips were then fixed to the middle phalanx. The dorsal traumatic central slip was stitched with lateral bands using 2-0 suture to form a new conjoint tendon. The injured central slip in the comparison group was sutured using autogenous palmaris longus tendon and fixed in drilled holes in the middle phalanx. Outcomes assessment was performed according to Dargan's criteria during postoperative follow-up. Motion range in the proximal turndown group was significantly greater than in the graft group (p < 0.05). We observed no boutonniere deformity in both the proximal turndown and graft group.