PMC6742862_01
Clinical picture at the time of presentationshowing an inability to flex the DIP joint of the ring finger.
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F1
When asked to make a fist, his ring finger remained extended at the DIP joint (Fig.1).
Radiograph at the time of presentation showing a large extra-articular fractured bony fragment of proximal phalanx lying in front of the middle phalanx.
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F2
We ordered radiographs of the hand in AP and oblique views with special focus on the ring finger and found that a fractured fragment from the distal phalanx was lying there in front of the middle phalanx (Fig. 2). 2 days after his visit, he was posted for surgery.
Intraoperative picture showing "flexor digitorum profundus" tendon exposed after cutting its sheath.
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F3
After a careful freshening of the margins, the bony fragment along with the attached tendon was reduced anatomically, and fixation was achieved using two K-wires (Fig. 3, 4, 5, 6, 7, and 8).
Intraoperative picture showing the flexor digitorum profundustendon attached to the bony fragment.
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F4
After a careful freshening of the margins, the bony fragment along with the attached tendon was reduced anatomically, and fixation was achieved using two K-wires (Fig. 3, 4, 5, 6, 7, and 8).
Intraoperative picture showing the normal anatomical location of the bony fragment.
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F5
After a careful freshening of the margins, the bony fragment along with the attached tendon was reduced anatomically, and fixation was achieved using two K-wires (Fig. 3, 4, 5, 6, 7, and 8).
End of the bone being the fresh end.
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F6
After a careful freshening of the margins, the bony fragment along with the attached tendon was reduced anatomically, and fixation was achieved using two K-wires (Fig. 3, 4, 5, 6, 7, and 8).
Intraoperative picture showing the reductionof the bony fragment with attached tendon and fixation achievedusing two percutaneous K-wires.
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F7
After a careful freshening of the margins, the bony fragment along with the attached tendon was reduced anatomically, and fixation was achieved using two K-wires (Fig. 3, 4, 5, 6, 7, and 8).
Post-operative X-ray showing fixation of the bony fragment with two K-wires.
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F8
After a careful freshening of the margins, the bony fragment along with the attached tendon was reduced anatomically, and fixation was achieved using two K-wires (Fig. 3, 4, 5, 6, 7, and 8).
Post-operative function at 6 months.
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F9
At present, he is able to make a complete fist and is able to do all his routine activities without any difficulty (Fig. 9, 10, and 11).
1-year post-operative radiograph showing complete union.
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F10
At present, he is able to make a complete fist and is able to do all his routine activities without any difficulty (Fig. 9, 10, and 11).
Post-operative function after 1 year.
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F11
At present, he is able to make a complete fist and is able to do all his routine activities without any difficulty (Fig. 9, 10, and 11).