A novel technique of pulley creation for additional sagittal band reconstruction.

Because surgical treatment of chronic extensor tendon dislocation with sagittal band injury is complex and often requires donor grafts, we suggest a new technique: pulley creation for additional sagittal band reconstruction. A 76-year-old man diagnosed with chronic extensor tendon dislocation with radial sagittal band injury was treated by resecting the distended portion of the radial sagittal band, followed by plication. Using the remnant tissue obtained after resection, additional sagittal band reconstruction was performed using two mini soft suture anchors in the form of a pulley surrounding the extensor tendon. Three-year outcome was satisfactory. Pulley creation for additional sagittal band reconstruction with direct repair of the radial sagittal band is a new surgical option for chronic extensor tendon dislocation. The technique is quick and easy, with good patient satisfaction and no donor site complications.