PMC9210073_01
The patient was not able to actively flex the distal interphalangeal joint of her little finger.
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After that, she was not able to actively bend the DIP joint of the little finger; however, she was able to actively flex the finger at the proximal interphalangeal (PIP) joint (Figure 1).
Anteroposterior radiographs of the left wrist showed the cystic lesion of the hamate and osteosclerosis of the pisiform.
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Anteroposterior radiographs of the left wrist showed a cystic lesion of the hamate and osteosclerosis of the pisiform (Figure 2).
(a) Ultrasonography (sagittal view) showing the bulge of the flexor profundus tendon of the little finger (arrow) at the palm and distal forearm levels. (b) Ultrasonography (sagittal view) showing the bulge of the flexor profundus tendon of the little finger (arrow) at the distal forearm level.
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A sagittal ultrasound (US) view showed a bulge at the flexor digitolum profundus (FDP) tendon of the little finger at the palm and distal forearm levels (Figure 3(a) and (b)).
(a) CT (axial view) showing cortical bone irregularities of the hamate adjacent to the cystic region (arrow). (b) CT (axial view) showing the PT joint space narrowing and the bony spur on the radial side of the pisiform (arrow).
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Computed tomography (CT) showed the cortical bone irregularities of the hamate adjacent to the cystic region (Figure 4(a)) and pisotriquetral joint space narrowing and a bony spur on the radial side of the pisiform (Figure 4(b)).
The capsule of the PT joint was torn on the radial side (arrow).
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The capsule of the pisotriquetral joint was torn on its radial side (Figure 5).
The flexor tendon floor on the hamate was intact (arrow).
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On the contrary, the flexor tendon floor on the hamate was intact (Figure 6).
The tip of the tendon stump (arrow) reached the exposed joint site when the distal tendon stump was pulled centrally.
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When the distal tendon stump was pulled centrally, at that time, the little finger passively exhibited full flexion; the tip of the tendon stump reached the exposed joint site (Figure 7).
The articular surface of the pisiform was eburnated and osteocytes were observed (arrow).
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The articular surface of the pisiform was eburnated (Figure 8).
(a), (b) At 10 months after surgery, the little finger had an active range of motion of 0 -90  at the matacarpophalangeal joint, 0 -90  at proximal interphalangeal joint, and 0 -70  at the DIP joint.
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At 8 months after the operation, the grip strength of the affected hand was 16.3 kg, while that on the unaffected side was 19.1 kg and she could move the affected finger with full flexion and extension (Figure 9(a) and (b)).