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This case report describes the rare occurrence of a flexor digitorum profundus (FDP) avulsion of the left little finger in association with a pathological fracture of an enchondroma. The enchondroma was treated by simple curettage without bone graft. The FDP tendon was re-attached to the distal phalanx using the pull-out technique with a non-absorbable polyethylene suture.
We recommend simple curettage without bone grafting in cases of enchondroma of the distal phalanx in which the bone defect is small.
Dislocation of the trapeziometacarpal joint is a rare injury. We report an unusual pattern of dorsal dislocation of the trapeziometacarpal joint with an avulsion fracture of the dorsoradial tubercle of the trapezium. Simultaneous ligament rupture with an avulsion fracture of the thumb metacarpophalangeal joint was associated. The trapeziometacarpal joint was reduced and disrupted ligaments with avulsed fragments of both joints were surgically repaired.
Avulsion fractures at the base of the index finger or long finger metacarpals are rare. We found six cases in the English language of a similar injury involving the extensor carpi radialis brevis. All were treated surgically. We describe an isolated avulsion fracture injury of extensor carpi radialis brevis insertion treated satisfactorily without surgery. The patient healed uneventfully and returned to normal pain free activity.
Avulsion fracture of the volar base of the distal phalanx is a rare injury. Zone 1 flexor tendon injuries can be treated with either internal or external fixation techniques. Pull-out suture repairs are often used for FDP tendon avulsion injuries. However, the pull out suture technique is associated with a number of well documented complications including nail bed injury and pressure necrosis. Despite the variety of techniques available for the repair of acute distal zone 1 flexor tendon injuries, no one technique has proven to be superior to all others. We address our experience with treatment of FDP avulsion injuries using suture anchor and miniscrew. Our technique supplements the suture anchor technique, which often causes a lack of strength, with an additional miniscrew. We introduce two cases of combined method using both suture anchor and miniscrew for treatment of FDP avulsion injuries.
Flexor Digitorum Profundus avulsion injury associated with an enchondroma at the level of the distal phalanx is extremely rare. There have been few cases reported to date and most have been surgically managed using a screw and/or Bunnell pull-out wire technique with or without bone grafting. We describe the first case using a simple interosseus fixation technique for the reattachment of FDP tendon without bone grafting. The patient made an excellent post-operative recovery. This technique is a simple, effective, patient-friendly and internalised solution which, in addition, may prevent the need for bone grafting.