Extensor tendon joint anchorage: a novel technique for surgical repair of sagittal band rupture

Purpose: Sagittal band rupture destabilizes the extensor digitorum communis tendon at the metacarpophalangeal joint, causing pain, swelling, and subluxation. This study introduces the extensor tendon joint anchorage (ETJA) technique, which was designed to restore tendon stability while preserving full finger motion.Methods: A retrospective review was conducted of 36 patients who underwent ETJA repair between January 2023 and December 2024. All patients had painful metacarpophalangeal joint tendon instability and had either failed conservative management or been considered unsuitable for nonoperative treatment. The ETJA technique involved direct anchoring of the tendon to the metacarpophalangeal joint capsule with three sutures. Postoperatively, patients were immobilized in extension for 3 weeks, followed by progressive range-of-motion and strengthening exercises under a standardized rehabilitation protocol.Results: The mean age was 37.4 years, and the middle finger was most commonly involved; the radial side accounted for 86.1% of cases. The mean interval from injury to surgery was 11.4 weeks, and the mean rehabilitation period was 2.8 weeks. At a mean follow-up of 15.6 weeks, flexion and extension recovery averaged 99.5% and 98.9%, respectively, and the mean visual analog scale score was 1.9. One patient experienced recurrent rupture at 3 months and underwent repeat repair using the ETJA technique, with no further recurrence thereafter.Conclusion: The ETJA technique provided reliable stabilization of the extensor tendon without compromising motion. Direct anchoring to the joint capsule achieved secure tendon centralization, predictable functional recovery, and early return to activity.