title: Zone 2 flexor digitorum profundus and superficialis rupture treated with single-stage tendon reconstruction using an Active Hunter Rod Implant.
abstract: To our knowledge, no report has been published of a flexor tendon rupture as a result of a closed phalangeal fracture.A 58-year-old woman with multiple medical comorbidities presented with a closed, apex volar fracture of her long finger proximal phalynx with clinically intact flexor digitorum profundus and superficialis tendons in zone 2 of the flexor tendon sheath. After 5 weeks of nonoperative treatment, the patient reported hearing a pop in her finger, and clinical findings suggested rupture of the flexor digitorum profundus and superficialis tendons. Intraoperatively, the nonreparable attritional rupture was underneath the A2 pulley. A bony prominence in the tendon sheath floor from the healed phalynx fracture made rerupture a concern with a tendon graft. A Hunter Active Tendon Implant (Wright Medical Technology, Inc, Arlington, Tennessee) was used to reconstruct the flexor digitorum profundus tendon to avoid a second procedure. The patient progressed well and had regained a functional arc of active finger range of motion by 2 months postoperatively.The Hunter Active Tendon Implant provided a suitable alternative to a 2-staged procedure, with the added benefit that a good tendon bed was developed in the event that a second procedure was needed.
authors.affiliation: Department of Orthopaedics, University Hospitals Case Medical Center, Ohio, USA.
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: Macknin
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Malone
mesh_terms: D005260:Female; D005383:Finger Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D005384:Finger Joint / Q000503:physiopathology / Q000601:surgery; D050723:Fractures, Bone / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D008875:Middle Aged; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods*; D020127:Recovery of Function; D012421:Rupture; D013708:Tendon Injuries / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome