Sagittal band reconstruction (Middle finger)


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Learn the Sagittal band reconstruction (Middle finger) surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Sagittal band reconstruction (Middle finger) surgical procedure.

This is a detailed step by step instruction through a Middle finger Sagittal band reconstruction using a central segment of the extensor apparatus to realign and hold the extensor tendon in place during metacarpo-phalangeal joint (MCPJ) flexion.

It is performed through a dorsal midline approach.

This method is a modification of that published by Charles Carroll in 1987 (see results section).

This is a procedure performed when the sagittal band, usually the radial sided band, ruptures. This is most commonly as a result of inflammatory arthritis but may also be required in neglected traumatic ruptures where a primary repair is not possible.

The procedure can be performed as a day case under regional or general anaesthetic and takes around 1 hour.

Following a period of 1 week in plaster cast the patient then starts mobilisation with active flexion and extension and a volar based splint which limits MCPJ flexion to 30 degrees for 2 weeks, 60 degrees for 2 weeks then 90 degree for the final 2 weeks.

The joint will always appear swollen however the majority of post operative swelling will resolve by 3 months.


Author: Mr Mark Brewster FRCS (Tr & Orth)

Institution: The Royal Orthopaedic Hospital, Birmingham ,UK.

  • Each operation and the questions associated become a named course in the CPD section
  • The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
  • You’ll need to tick the box to confirm this has been done and can do this immediately if you have already read the op tech.
  • The vast majority of operations have a 10-15 MCQ quiz covering all aspects of the decision making and the technique
  • There are four possible answers of which one is correct (or on occasion more correct) than the others.
  • There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
  • The course is completed once all the lessons are read and quizzes submitted and passed.
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  • The timer suspends after 5 minutes though if there is no activity.
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    The pass mark is 75%.
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CPD Points:

  • Operation Quiz – 1 CPD point
  • Surgical steps Quiz – 1/4 CPD point
  • Implants Quiz – 1/4 CPD point
  • Problem case Quiz – 1/2 CPD point

One CPD point equates to one hour of academic activity


Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.

Our content is designed for both Surgeons in independent practice and Surgeons in training.


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