Armandeep Bedi
Princess of Wales hospital, United KingdomTitle: A rare presentation of flexor digitorum profundus injury with avulsion of a large extra-articular bony fragment
Abstract
Background: Flexor digitorum profundus (FDP) avulsion injury, also known as "jersey finger," occurs following hyperextension of the distal interphalangeal joint (DIPJ) against contracted flexion force in young adults involved in athletic activities.
Case report: The current report presents a rare and unusual presentation involving a 56-year-old female with a closed traumatic avulsion of FDP, with a very large extra-articular fragment of the distal phalanx attached to it, lying in front of the middle phalanx. The patient presented to the emergency department with a swollen, bruised, painful left little finger and an inability to flex DIPJ. The injury was sustained while she was trying to grab her dog's collar when it was trying to run away—an unusual and rare mechanism of the injury. Radiographs revealed a very large extra-articular fragment of the distal phalanx lying in front of the middle phalanx, the size of which was about 80% of the total distal phalanx length. The proximal articular block and the tip of the distal phalanx were intact and remained in situ. The patient underwent surgical exploration 3 days later, with a volar Brunner incision, reduction of the proximally retracted fragment to which the FDP tendon was found to be attached, and stabilisation with 0.9mm trans-articular K-wire. Post-operatively, the finger was immobilised in a thermoplastic splint, and, after confirming radiological union, K-wire was removed at 6 weeks and DIPJ mobilisation was started.
Conclusion: This case highlights the unusual mechanism of injury in combination with a rare pattern of large fragment avulsion.
Biography
Armandeep Bedi, Junior Clinical Fellow at Princess of Wales hospital, United Kingdom
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