Littler technique for repair of old boutonniere deformity. A, Typical deformity with flexion of proximal interphalangeal joint and extension of distal interphalangeal joint. Lateral bands have subluxated volarward. B, Dorsal curved longitudinal incision is made. C, Insertions of lateral bands are completely freed except for radialmost fibers of radial lateral band. D and E, Lateral bands are shifted dorsally and proximally and are sutured together and to soft tissues over proximal third of middle phalanx and to central tendon. F, Proximal interphalangeal joint (PIP) is fixed in full extension by Kirschner wire. G, After repair, proximal interphalangeal joint is extended by extensor hood and distal interphalangeal joint by preserved lumbrical muscle and oblique retinacular ligament. SEE TECHNIQUE 66.28.