previous section: 1/5 page: 3/8 next

1Principles

Tendon rupture at its insertion at the distal phalanx, without a bony fragment.

Classification

A useful classification for this type of injury comes from Leddy and Packer.

Type I
Tendon rupture at its insertion at the distal phalanx, without a bony fragment. The tendon is retracted, often into the palm, where it can be palpated. The patient feels some tenderness or pain where the tendon is located.
The vincular arteries are ruptured, impairing the vascularity of the flexor tendon.

Success of treatment of this injury relies heavily on

  • accuracy of diagnosis
  • rapid surgical intervention

 

The flexor digitorum profundus (FDP) tendon must be repositioned and reinserted. This is not possible after 10 days following the injury because of:

  • tendon swelling
  • collagen regeneration
  • Muscle contracture

Reinsertion after this period will lead to a significant flexion contracture of the finger (myostatic contracture).