A subacute case of traumatic avulsion of the flexor digitorum profundus tendon due to recurrent enchondroma of the distal phalanx

Un caso subacuto di avulsione traumatica del tendine flessore profondo associata a encondroma ricorrente della falange distale

Danila Oldani 1, Silvio Tocco 2, Letizia Marenghi 1

1 Clinica Ortopedica, Dipartimento Chirurgico generale e Specialistico, Università di Parma; 2 Centro Riabilitativo della Mano e Arto Superiore, Parma

DOI 10.53239/2784-9651-2022-4

Introduction. Avulsion of the flexor digitorum profundus (FDP) tendon associated to an enchondroma fracture in the distal phalanx is very rare. We report a subacute case of a type II FDP tendon avulsion of the small finger at its insertion, in combination with a fracture of the distal phalanx due to enchondroma. 

Material and methods. The bone lesion was curetted and grafted using autogenous bone harvested from the ipsilateral radius. The FDP tendon was reattached to the distal phalanx using the pullout transosseous technique. Delayed protected active mobilization was used to treat the repaired tendon.

Results. According to the adjusted Strickland score, a good result was obtained and grip strength was similar between hands and PRWHE score was very low at 5 months from surgery. 

Conclusions. Early diagnosis leads to a fast surgery with good functional mobility and pain outcomes. If closely monitored by an experienced medical team, as this case demonstrates, an attempt to treat the benign tumor with a curettage, bone filling and reattachment of the tendon through the pullout technique in young motivated patients can be an alternative.

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