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. 2024 Apr 16;16(1):100006.
doi: 10.1055/s-0042-1751276. eCollection 2024 Mar.

Closed Traumatic Avulsion of Both Flexor Digitorum Tendons: An Addition to the Leddy and Packer Classification and Review of the Literature

Conor Cuggy  1 , Jack F C Woods  1 , Emma Carr  1 , Natalie Jumper  1 , Nicola Lynch  1 , Roisin Dolan  1
Affiliations

Closed Traumatic Avulsion of Both Flexor Digitorum Tendons: An Addition to the Leddy and Packer Classification and Review of the Literature

Conor Cuggy et al. J Hand Microsurg. .

Abstract

Objective: We encountered the case of a patient who presented with an avulsion of both flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendons from their respective insertion in the ring finger. We aim to discuss the novel treatment of this injury pattern in the context of all previously encountered cases in the literature.

Materials and methods: We examined the case of our patient with avulsion of both flexor tendons in the same finger and discuss the novel method of treatment in our case. Additionally, we performed a literature review of all previous reported cases and discuss the treatment modalities and outcomes associated with each.

Results: We have shown a novel and successful treatment technique for avulsion of both the FDP and FDS tendons. We identified twelve other cases of this injury pattern and have compared all outcomes documented.

Conclusion: Closed tendon avulsion of both flexor tendons in the same finger is rare. We described a case and additionally propose a modification to the flexor tendon avulsion classification to incorporate this injury pattern and aid its management.

Keywords: FDP and FDS avulsion; FDP avulsion; Leddy and Packer classification; anchor reinsertion.

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Figures

Fig. 1
Fig. 1
(A, B) Clinical presentation. (C, D) X-ray images at presentation with no bone avulsion injury. (E) US images showing a reported 2.49-cm gap in the FDP tendon. FDP, flexor digitorum profundus; US, ultrasound.
Fig. 2
Fig. 2
(A) Tendons retrieved proximally. (B) FDS repaired at insertion, as indicated by the forceps. This FDP is turned backward and overlies the A2 pulley to show the insertion of the FDS tendon. (C) Both FDS and FDP tendons repaired before skin closure. FDP, flexor digitorum profundus; FDS, flexor digitorum superficialis.
Fig. 3
Fig. 3
(A–D) Clinical outcome after completion of 12 months of follow-up. (E, F) X-ray outcome at completion of 12 months of follow-up.
See this image and copyright information in PMC

References

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