Finger flexion after amputation through the proximal phalanx with and without flexor digitorum superficialis tenodesis

Introduction: Some authors have suggested that metacarpophalangeal joint (MCPJ) flexion is limited to 45° after finger amputation through the proximal phalanx. The aim of this study was to investigate if flexor digitorum superficialis (FDS) tenodesis improves MCPJ flexion. Methods: Patients who had had a FDS tenodesis between April 2022 and April 2023 were included in this study, and their outcomes were compared with patients who had received a conventional amputation between June 2018 and January 2023. All patients were invited to come to the hospital for follow-up to measure the MCPJ range of motion. Adverse events and pain were also assessed. Results: Twenty patients (25 fingers) without FDS tenodesis and 11 patients (13 fingers) with FDS tenodesis with a median follow-up of 21 (range 7–60) and 6 (range 2–12) months, respectively, were included in the study. Mean MCPJ flexion was 78° (SD 17, range 32–110) after conventional amputation and 86° (SD 8, range 70–95) after FDS tenodesis. Mean MCPJ extension was 6° (SD 9) in the conventional group and 7° (SD 6) in the FDS group. Adverse events were recorded in 20/25 fingers in the conventional group and 8/13 fingers in the FDS group. Pain was reported in 3/25 fingers after conventional amputation and 1/13 fingers after FDS tenodesis. Conclusion: The MCPJ flexion was almost normal after finger amputation through the proximal phalanx. While FDS tenodesis appeared to be safe, no advantage could be shown over conventional amputation. Owing to the lack of clinical benefit, we have abandoned the technique in our practice. Level of evidence: III