Ultrasound visualization of central slip injuries of the finger extensor mechanism.
OBJECTIVE
To evaluate the ability of ultrasound to detect a central tear of the finger extensor tendon mechanism.


METHODS
Twelve fresh-frozen and thawed cadaver fingers were used. All fingers had a midradial incision with exposure of the extensor mechanism over the proximal interphalangeal joint. Six fingers had a sharp transection of the central slip. The other 6 fingers were used as sham dissection controls. All fingers had the exposure closed by suture and then were examined by a musculoskeletal ultrasonographer.


RESULTS
All 12 fingers were identified correctly as either sham controls with intact central slips or as injury models that had a transected central slip. Thus there was a sensitivity of 100% a specificity of 100%, and a positive predictive value of 1.000, which were statistically significant.


CONCLUSIONS
Diagnostic ultrasound is a very accurate noninvasive study that can identify central slip injuries in the extensor mechanism of the finger. We recommend that clinically suspected cases of boutonniere injury be scanned by high-frequency ultrasound to confirm the diagnosis and allow either early initiation of splinting or eliminate the need for prolonged splinting required for this injury.
Westerheide
Edward
E
Department of Orthopaedic Surgery and Department of Musculoskeletal Radiology, Henry Ford Hospital, Detroit, MI, USA.
Failla
Joseph M
JM
van Holsbeeck
Marnix
M
Ceulemans
Ruth
R
D005383:Finger Injuries / Q000000981:diagnostic imaging*; D006801:Humans; D012421:Rupture; D012680:Sensitivity and Specificity; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000628:therapy; D013710:Tendons / Q000000981:diagnostic imaging*; D014463:Ultrasonography