We reported a modified Littler's procedure for the treatment of swan neck deformities. In this procedure the ulnar side of the lateral band which was rerouted to the radial side between flexor sheath and neurovascular bundle, was sutured to the proximal part of the radial side of the lateral band to obtain dynamic tenodesis effect. The tension of the rerouted lateral band was determined by the maximum tension positioning PIP joint in 20 degrees of flexion and DIP joint in 0 degree extension. By our modified procedure, dynamic block of hyperextension in PIP joint and dynamic increase of extension in DIP joint were obtained more functionally than original Littler's procedure.
