Objective: A large number of surgical techniques have been applied in the attempt to find an ideal method in treating the mallet finger after failure of conservative treatment. However, the optimal method is still unknown. The aim of this study is to evaluate a new reliable surgical technique for tendinous mallet finger repaired by Massachusetts General Hospital (MGH) method with a bone anchor followed by reverse lateral band slips in vitro. Materials and Methods: Sixteen fingers were obtained from 10 fresh-frozen cadaver hands and made into mallet finger models by terminal tendon laceration. All the lacerations were repaired by MGH method with a bone anchor fixed in distal phalanx and then divided into 2 groups. Reverse bilateral band slips were further used to supplement the repair for half of the 16 fingers (group 2). The tendon slips were carefully harvested from the bilateral band of proximal one-third of middle phalanx. The width of the slip was no more than one-fourth of the lateral band (about 1 mm for index, middle, and ring finger, and for little finger, it is about 0.8 mm). Then the harvested bilateral band slips were reversely sutured close to the extensor tendon insertion with cruciate path to cover the repair site, suture, and knots. After the procedure, all the repaired tendons with the distal phalanx were collected to detect the repair strength. Ultimate strength was evaluated as biomechanical performance for two groups. Rupture pattern was also recorded for each specimen. Results: The MGH repair with reverse bilateral band slips had a significantly higher ultimate tensile strength (43.9 N; SD, 7.9 N) than the MGH repair only (33.1 N; SD, 3.7 N). One rupture was found at partial lacerated lateral band in one initial specimen of reverse lateral band slips, due to improper operation. All the other ruptures occurred at the suture or the knots. Conclusions: Supplement with the reverse bilateral band slips can enhance the tensile strength of extensor tendon injury repaired by MGH method. Slip with no more than one-fourth width of lateral band carefully harvested cannot increase the risk of lateral band rupture. Usage of the reverse lateral band slip can cover the repair site and reduce the exposure of the stitches. It is a useful, reliable, and alternative technique for the treatment of tendious mallet finger using reverse lateral band slips after MGH repair with a bone anchor.
