Simultaneous Dorsal Base Fracture and FDP Avulsion of Distal Phalanx of the Little Finger

Document Type : CASE REPORT

Authors

Shohada Teaching Hospital Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Avulsion injury of the flexor digitorum profundus (FDP) with concomitant fracture of the distal phalanx dorsal base is
uncommon. Simultaneous avulsion fractures of the insertion of this tendon associated with rupture of the tendon from
the bony fragment and combination with dorsal base fracture is very rare and also complicated. A 36- year- old man
fell and injured his right little finger. FDP avulsion with simultaneous dorsal base fracture (containing extensor Tendon
insertion) was detected. Our surgical repair by a single midlateral incision the avulsed fragment was replaced on the
palmar base of the distal phalanx and successfully immobilized with 1.5 mm screw. After three months, patient had 20
degree range of motion in DIP joint. The digit was pain free and also relatively functional. It seems that FDP avulsion
classification need to be extended and include this uncommon type as described in this case report for better management
of these uncommon type.

Keywords

References

  1. Boyes JH, Wilson JN, Smith JW. Flexor-tendon ruptures in the forearm and hand.  J Bone Joint Surg Am. 1960; 42: 637-46.

  2. Carroll RE, Match RM. Avulsion of the flexor profundus tendon insertion. J Trauma.1970; 12: 1109-18.

  3. Al-qattan MM. Type 5 avulsion of the insertion of the flexor digitorum profundus tendon. J Hand Surg Br. 2001;26:427-31.

  4. Buscemi MJ, Page BJ. Flexor digitorum profundus avulsions with associated distal phalanx fractures. A report of four cases and review of the literature. Am J Sport Med. 1987; 15(4):336-70.

  5. Smith JH. Avulsion of a profundus tendon with simultaneous intra-articular fracture of the distal phalanx case report. J Hand Surg Am. 1981;6(6):600-1.

  6. Leddy JP. Avulsion of the flexor digitrum profundus. Hand Clin.1985;1(1):77-83.

  7. Leddy JP, Packer JW. Avulsion of the profundus tendon insertionin athletes. J Hand Surg Am. 1977;2:66-9.

  8. Hohl JB, Hyman JE, Strauch RJ. Rupture of the Flexor Digitorum Profundus in a Preadolescent Boy. Am J Orthop. 2008;37(4):210-2.

  9. Xarchas KC, Tilkeridis K, Kitsikidou G, Pelekas SI, Verettas DA. Complete Avulsion of the Extensor Mechanism of a Finger with Simultaneous Dislocation of the Proximal Interphalangeal Joint. Open Orthop J. 2009; 3: 75–7.

  10. Henry SL, Katz MA, Green DP. Type IV FDP Avulsion: Lessons Learned Clinically and Through Review of the Literature. Hand (N Y). 2009;4:357–61.

  11. Ehlert KJ, Gould JS, Black KP. A Simultaneous Distal Phalanx Avulsion Fracture With Profundus Tendon Avulsion: A Case Report and Review of the Literature. Clin Orthop Relat Res.1992;283:265-9.

  12. Takami H, Takahashi S, Ando M,Masuda A. Flexor digitorum profundus avulsion with associated fracture of the distal phalanx. Arch Orthop Trauma Surg. 1997; 116: 504-6.

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History

  • Receive Date: 05 September 2013
  • Revise Date: 16 October 2013
  • Accept Date: 30 November 2013

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