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Case report
Closed rupture of flexor digitorum profundus in zone III
  1. Ryan James Bickley1,
  2. James Banks Deal1,
  3. Ryan Luke Frazier2 and
  4. William Etzler Daner1
  1. 1Orthpaedic Surgery, Tripler Army Medical Center, Honolulu, Hawaii, USA
  2. 2F Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
  1. Correspondence to Dr Ryan James Bickley; ryan.j.bickley{at}gmail.com

Abstract

Closed ruptures of the flexor digitorum profundus (FDP) tendon cause a loss of active flexion at the distal interphalangeal joint. Commonly referred to as a ‘jersey finger’ because of its association with tackling sports, the distal aspect of FDP is avulsed from its insertion on the distal phalanx in zone I, with or without a fragment of bone. Because of this classic injury mechanism and pattern, providers may not seek advanced imaging beyond plain radiographs. Although rare, injury to FDP more proximally may occur. More often this injury is associated with a weak underlying tendon because of repetitive microtrauma or anomalous anatomy, for example. We present a case of a closed rupture of the FDP in zone III, and stress the importance of maintaining a high clinical suspicion and the potential use of adjunct ultrasound imaging to localise the site of injury.

  • orthopaedics
  • tendon rupture
  • orthopaedic and trauma surgery

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Footnotes

  • Contributors RJB cared for this patient as the junior resident on call, participated in his initial surgery and aftercare, and primarily wrote this manuscript. JBD cared for this patient as the senior resident on call, participated in his initial surgery and aftercare, and heavily edited this manuscript. RLF assisted in the care for this patient, as well as helped primarily write the manuscript. WED cared for this patient as the staff surgeon on call, participated in his initial surgery and aftercare, and heavily edited this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The views expressed in this manuscript are those of the authors, and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.