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We report the results of long-term follow-up after Vickers' physiolysis of the trapezoidal delta phalanx in a boy aged five year and six months with bilateral clinodactyly of the little finger. Radial deviation of the little finger was corrected from 36° to 15° on the left, and from 35° to 15° on the right at last follow-up six years and five months after surgery. The patient's parents were satisfied with the cosmetic appearance. X-ray film showed the abnormal distal epiphyses of the middle phalanges of the little fingers had disappeared.

A 59-year-old man suffered from subcutaneous rupture of the flexor tendon of the little finger associated with fracture of the hook of hamate. He could not flex his little finger completely at the distal interphalangeal joint, but incomplete flexion of the proximal interphalangeal joint was possible. Surgical exploration revealed anomaly of the flexor digitorum superficialis of the little finger, as it originated from the palmar aspect of the carpal ligament, and a small portion of the muscle belly was traversed toward the A1 pulley over the profundus tendon and then it ran into the A1 pulley as a normal superficialis tendon.

The flexor digitorum superficialis of the little finger is well known to show variations, but our case is extremely rare, and furthermore there are no reports in the available literatures about the function of this anomalous muscle.

During a wrist ganglion excision originating at the tendon sheath of the extensor carpi ulnaris muscle, a soft tissue mass was observed just radial and distal to the surgical field. Dissection of the mass revealed an accessory extensor digiti minimi muscle belly which joined the radial extensor digiti minimi tendon. The surgical impact is discussed.

We treated a rare case of locked metacarpophalangeal joint of the little finger due to a hyperextension injury. The mechanism of the occurrence was considered to be closely similar to those that happened in the thumb, and the locking was successfully released by a manual reduction without complication.

The cases of two patients, a four-year-old boy and an eight-year-old boy, who had been incapable of active flexion of the little finger since birth, are presented. They were capable of active flexion of the metacarpophalangeal (MP) joint, but not of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints. They were diagnosed with a defect of the flexor digitorum profundus (FDP) tendon of the little finger and underwent surgery. In both cases, the FDP tendon turned into fibrous tissue proximal to the palm and lost continuity on this side. Reconstruction was performed by making an end-to-side anastomosis of the residual proximal end of the FDP tendon to the FDP tendon of the ring finger in the palmar region. Although one patient required repeated surgery due to post-operative tendon adhesion, good outcomes were achieved, with both patients becoming capable of active flexion.

Background: Finger injuries are common in the sport of hurling. Injury to the little finger distal interphalangeal joint (DIPJ) often occurs when a high dropping ball impacts on the outstretched finger. The little finger contributes to approximately 15% of grip strength. Injury therefore results in reduced grip strength and may impair the ability of players to grip or catch a ball.

Methods: Six elite hurlers with post-traumatic arthritis of their non-dominant little finger DIPJ underwent arthrodesis in 30 degrees of flexion. Kirchner wires were inserted for up to 8 weeks to achieve fusion of the joint. Patients were evaluated after recovery using a dynamometer to assess grip strength, the DASH questionnaire and a sport specific questionnaire.

Results: All arthrodeses achieved bony union without complication. All patients reported a resolution of their pain and recovery in their ability to catch & retain a ball. Measurements of grip strengths were comparable between hands. DASH scores improved by up to 47 points. All scores were less than 5 at final follow-up.

Conclusions: Grip strength decreases when fingers are immobilized in full extension. In sports that require catching or gripping a ball or a bat, arthrodesis of the DIP joint in flexion can improve grip strength and hand function. Fusion in 30 degrees of flexion for hurlers results in restoration of function and resolution of pain. Little finger DIPJ arthrodesis is a valid method of treating posttraumatic arthritis in ball and bat sports.

We managed a case of locked metacarpophalangeal joint of the little finger in the extension position. Incarceration of a chronic osteochondral fracture fragment led to this unique condition. The fracture fragment partially adhered to the volar plate and ulnar collateral ligament on the joint side, which is supposed to have resulted in manually irreducible locking of the joint. We performed open reduction and achieved release of the locked joint by excising the fracture fragment.

Background: The little finger metacarpal neck fracture, also known as boxer’s fracture, is a commonly encountered upper limb fracture in orthopaedics. There are multiple ways of managing this fracture, ranging from immediate mobilization to rigid internal fixation. However, there is still a lack of consensus on the best management option. The aim of this study is to review all comparative studies, either randomized trial or cohort studies, on little finger metacarpal neck fracture management, meta-analyze the radiological and functional outcome between conservative and operative management.

Methods: A systematic search of the literature was conducted between year 1987 to 2018 on MEDLINE and EMBASE. To be included, studies needed to have shown comparison between conservative against operative management, assessing the radiological (palmar angulation) and the patient reported functional outcomes. The data were pooled using fixed-effect method. The methodology was adapted from the Cochrane Handbook for Systematic Review of Interventions and compliant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PROSPERO CRD42018099168).

Results: 5 full papers were included in our study. Our meta-analysis showed that compared to operative management, conservative management report worse radiological palmar angulation at follow-up; but equivalent functional outcome in terms of Quick-DASH and grip strength. Conservative studies also showed fewer mean days off in comparison to operative management. Conservative management also showed equivalent Total Active Motion (TAM) and Visual Analogue Score for Pain (VAS), but some studies had insufficient data to be pooled.

Conclusions: Regardless of palmar angulation, conservative treatment of little finger metacarpal neck fracture provides an equivalent functional outcome to surgical intervention with an earlier return to work and no risk of surgical complications. Larger, randomised controlled trials are required.