Anterior tenoarthrolysis for severe flexion contracture of the fingers (the "tata" operation): A review of 50 cases

Abstract

The "hook finger", with both proximal interphalangeal (PIP) and distal interphalangeal (DIP) joint flexion contractures, often after multiple previous operations, is difficult to treat. This paper reports the results of 50 fingers in 49 patients in which the TATA (Teno-Arthrolyse Totale Anterieure) salvage procedure, described by Saffar in 1978, was carried out. Thirty-seven of 50 (74%) of these fingers had had at least one previous operation, most on the flexor apparatus. The mean PIP and DIP extension deficit pre-operatively was 133 degrees with a mean PIP lag of extension of 83 degrees. With a mean follow-up of 7.8 years, 45 fingers were improved, five were not and none was worsened. The mean PIP and DIP extension deficit postoperatively was 47 degrees, with a mean PIP lack of extension of 31 degrees. The overall gain in extension deficit of both joints was 86 degrees and of the PIP was 52 degrees. One PIP joint developed septic arthritis immediately after surgery. The benefit of this salvage operation is mainly in the change of the active range of motion to a more functional arc.