Case Report

Unusual Closed Traumatic Avulsion of Both Flexor Tendons in Zones 1 and 3 of the Little Finger

Table 1

Closed avulsion of both flexors in the same finger.

AuthorPatient age, sex, HDMechanism Finger(s)Site of rupture Days before surgery Technique Months of postsurgery follow-upSuccess

Our case30,
♂, R
Jersey finger D5 LFDS: zone 3
FDP: zone 1
0 FDP: pull-out, FDS: suture reinforced by a tendon graft 6E/F MCP: 0/0/95°, PIP: 0/10/85° DIP: 0/10/22°.
Back to work.

Cheung and Chow [3]24,
♂, R
Jersey finger D4 RFDS: zone 2
FDP: zone 1
4 Both tendons sutured to a periosteal flap and FDP reinforced by pull-out 3.5Full range of motion MP + PIP, flexum 4° DIP.
Back to work.

Oğün et al. [8]21,
♂, NM
Jersey finger D4 RFDS: zone 2
FDP: zone 1
0FDP: pull-out, FDS: resected19 Total active range of motion = 230°, flexum PIP, DIP stiffness.

Naohito et al. [7]49,
♂, L
Direct shockD5 RFDS: zone 2
FDP: zone 2
20 FDP: end-to-end suture, FDS resected 4E/F: MCP: 30/0/80; PIP: 0/40/85, DIP: 0/5/60.
Back to work.

Matthews and Walton [6]28,
♂, R
Repeated microtraumaD3 RFDS: zone 2 mi-P1
FDP: zone 2 mi-P1
14Two-stage repair: resection, silicone rod, reoperation at 10 weeks, palmaris longus graft.3.5Good result: normal flexion PIP, DIP stiffness.
Back to work.

Cañadas Moreno et al. [2]16,
♂, NM
Blast D2 L: FDP + FDS
D3 L: FDP + FDS
D4 + D5: FDP
FDS: zone 2
FDP: zone 1
04 FDP: pull-out, 2 FDS: anchor suture technique 4 monthsIPD: flexum 30° D2, D3, D5
3 yearsCompletely recovered.

Toussaint et al. [9]23,
♂, R
Blast D4 L
D5 L
FDS: zone 2
FDP dilacerated in zone 1 + volar plate pull-out
D1 FDP: pull-out, FDS: resected 7D4: PID: flexum 15°, PIP: flexum 10°.
D5: PID flexum 40°, PIP flexum 10°.
Back to work.

Backe and Posner [1]23,
♂, NM
Traction-hyperextension D4 RFDS: zone 2
FDP: zone 1
4 weeks Palmaris longus tendon graft NMComplete extension and active flexion to within 1.5 cm of the midpalmar crease. DIP stiffness. Back to work as truck driver.

Lanzetta and Conolly [4, 5]28,
♂, R
Traction-hyperextension D4 RFDS: zone 2
FDP: zone 1
3Two-stage repair: excision of both tendons, left plantaris tendon graft 9 weeks after the 1st surgery 4Recovery of full extension and flexion.
Back to work as a mechanic 4 months after 2nd surgery.

HD = hand dominance, R = right, L = left, NM = not mentioned, E/F = extension/flexion, MCP = metacarpophalangeal joint, PIP = proximal interphalangeal joint, and DIP = distal interphalangeal joint.