Wk 4, Case 4 - Review

Patient History

37-year-old male with right hand and 4th finger pain.

Findings

LIGAMENTS: Intact.

TRIANGULAR FIBROCARTILAGE COMPLEX: Not visualized.

OSSEOUS: No fracture or dislocations.

TENDONS: Complete rupture of the 4th flexor digitorum profundus (FDP) with a 4 cm gap. Its insertional fibers at the base of the 4th distal phalanx are visualized. The proximal FDP fibers margin are at the distal 4th proximal phalanx.] Short-segment split tear before the complete rupture is also appreciated with multifocal intrasubstance split tears proximally as it exits the carpal tunnel.

CARPAL TUNNEL AND GUYON’S CANAL: Not applicable.

GENERAL: Diffuse edema between the flexor digitorum profundus and the proximal phalanx and surrounding the palmar aspect of the 4th finger.

Impressions

1. Right hand 4th “climber's finger” .
2. Complete rupture of the 4th finger A3 and A4 pulleys.
3. Complete rupture of the FDP with a 4 cm gap. Distal fibers attached to the base of the 4th distal phalanx. Bowing of the proximal tendon fibers, which are located at the distal aspect of the 4th proximal phalanx.
4. Tendinosis with intrasubstance short-segment split tears involving the 4th FDP as it exits the carpal tunnel.