J Korean Soc Surg Hand.  2015 Jun;20(2):51-54. 10.12790/jkssh.2015.20.2.51.

Avulsion Rupture of Flexor Digitorum Profundus in Zone 1, Diagnosed in Early Stage

• Hong KD
• Sim JC
• Ha SS
• Kim TH
• Sung MC

• KMID: 2194099
• DOI: http://doi.org/10.12790/jkssh.2015.20.2.51

Abstract

Avulsion injury of the flexor digitorum profundus (FDP) tendon from the distal phalanx is considered as a rare injury. We report a patient who sustained a FDP tendon rupture insertion on her fifth finger as a result of a closed, hyperextension with no accompanying laceration or predisposing pathologic condition. Preoperative ultrasonography showed complete rupture of FDP and the gap between the tendon ends. According to the classification by Leddy and Pacter, this case is type II. The reconstruction of flexor tendon using pull-out suture and tie-over button. We are reporting a case with brief review of literatures.

Keyword

Tendon injury; Flexor digitorum profundus; Avulsion

MeSH Terms

Classification
Fingers
Humans
Lacerations
Rupture*
Sutures
Tendon Injuries
Tendons
Ultrasonography

Figure

• 

  Fig. 1. (A, B) Ultralsonography showing ill-defined low echoic lesion in right (RT) fifth finger proximal phalax level tendon area.

• 

  Fig. 2. Intraoperative photographs showing distal avulsion lesion and proximal stump of flexor digitorum profundus tendon.

• 

  Fig. 3. Intraoperative photographs showing reconstruction of flexor digitorum profundus tendon using pull-out suture and tie-over button.

• 

  Fig. 4. End result at 2 years, a total of 60° of strong flexion has been gained at the distal interphalangeal joint of fifth finger.

Reference

References

1. McMaster PE. Tendon and muscle ruptures: clinical and experimental studies on the causes and location of subcutaneous ruptures. J Bone Joint Surg Am. 1933; 15:705–22.

2. Leddy JP, Packer JW. Avulsion of the profundus tendon insertion in athletes. J Hand Surg Am. 1977; 2:66–9.

3. Smith JH Jr. Avulsion of a profundus tendon with simultaneous intraarticular fracture of the distal phalanx: case report. J Hand Surg Am. 1981; 6:600–1.

4. Chung DW, Han CS, Hwang JC. Closed rupture of flexor digitorum profundus in zone 1 by direct truma: a case report. J Korean Soc Surg Hand. 2008; 13:241–5.

5. Bynum DK Jr, Gilbert JA. Avulsion of the flexor digitorum profundus: anatomic and biomechanical considerations. J Hand Surg Am. 1988; 13:222–7.

6. Gunter GS. Traumatic avulsion of the insertion of flexor digitorum profundus. Aust N Z J Surg. 1960; 30:1–8.

7. Manske PR, Lesker PA. Avulsion of the ring finger flexor digitorum profundus tendon: an experimental study. Hand. 1978; 10:52–5.

8. Lunn PG, Lamb DW. “Rugby finger”: avulsion of profundus of ring finger. J Hand Surg Br. 1984; 9:69–71.

9. Green DP. Operative hand surgery. 3rd ed. New York: Churchill Livingstone;. 1993.

10. Park JS, Choi WK, Son S, Kwon HK, Song JM, Rah SK. Avulsion injury of the flexor digitorum profundus tendon: a case report. J Korean Orthop Assoc. 1996; 31:1105–8.