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Spontaneous mid-substance FDP rupture

Rehan Zahid, Uzair Qazi, Scott Farner
Christine M. Kleinert Institute
2021-01-31

Presenter: Rehan Zahid

Affidavit:
The fellow submitting the article has worked with the lead surgeon/supervising author and co-author in designing, acquiring and analyzing the data, and writing the manuscript of this case report.

Director Name: Michelle Palazzo, MD

Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand

Closed flexor tendon injuries often result from trauma resulting in sudden forceful extension of an actively flexed digit. While closed tendon injuries commonly occur as avulsions in zone I, spontaneous midsubstance flexor tendon ruptures are rare, especially in the absence of an underlying pathology. Diagnosing such injuries accurately can be challenging as well as critical.

We present a case of zone III spontaneous flexor tendon rupture of the long finger after a hyperextension injury. Surgical exploration was carried out, and the level of rupture identified intraoperatively. A side-to-side tendon repair was done using a Palmaris Longus tendon graft. No underlying pathology was found in this case.

This article emphasizes the importance of considering spontaneous mid substance ruptures, identifying the level of rupture as well pre-operative planning for such cases. It reviews the possible causes of spontaneous flexor tendon rupture and adds to our current limited knowledge of the pathology.

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