Arch Hand Microsurg.  2020 Mar;25(1):33-38. 10.12790/ahm.19.0042.

Mini-Plate and Screw Fixation Technique for Comminuted Flexor Digitorum Profundus Avulsion Fracture

• Choi HY
• Kim JH
• Noh YJ

• KMID: 2501108
• DOI: http://doi.org/10.12790/ahm.19.0042

Abstract

Avulsion fracture of flexor digitorum profundus (FDP) tendon is relatively rare fracture at the distal phalangeal base than avulsion fracture of terminal extensor tendon. Terminal extensor avulsion fracture, known as bony mallet finger, could be successfully treated by closed reduction and pinning, such as extension block technique. However, most of FDP avulsion fracture, known as Jersey’s finger, needed open reduction, because of the proximal migration of fracture fragment and difficulty of pin fixation. Up to date, most of FDP avulsion fractures were treated by open reduction and fixation by pull-out suture or suture anchor technique. We report a case of comminuted FDP avulsion fracture, successfully treated by open reduction and mini-plate and screw fixation technique.

Keyword

Flexor digitorum profundus avulsion; Jersey; Avulsion fractures

Figure

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  Fig. 1. Simple radiograph on right ring finger showing two fragments on the level of distal interphalangeal and the level of base of middle phalanx.

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  Fig. 2. (A) Computed tomography (CT) sagittal view showing two avulsed fragments. (B) CT-3D reconstruction view showing two avulsed fragments from volar side of distal phalanx.

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  Fig. 3. Magnetic resonance images showing avulsed fracture flexor digitorum profundus tendon from distal phalanx and its migration to the level of proximal interphalangeal joint.

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  Fig. 4. (A) loss of normal cascade (B) kinging of flexor digitorum profundus tendon with proximal migration (arrow) and its avulsion site (*). (C) Reduction and fixation with a two hole mini-plate and screws (arrow). (D) Intraoperative fluoroscopic images showing reduction status and fixation with a mini-plate and screws. (E) Restoration of normal cascade.

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  Fig. 5. (A) Bony union was achieved. (B) Full range of motion of ring finger at final follow-up.

Reference

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