Misleading fractures after profundus tendon avulsions: a report of six cases

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Trumble TE. Vedder NB. Benirschke SK. Department of Orthopaedics, University of Washington School of Medicine, J Hand Surg [Am]. 17(5):902-6, 1992 Sep. From 1986 to 1990, twelve patients were treated for avulsions of the flexor digitorum profundus in either the ring or the long finger. Six patients had misleading x-ray films because the tendon had retracted farther than the fracture pattern had suggested. All of these patients had avulsion fractures from the palmar aspect of the distal phalanx. Although the classification of Leddy and Packer is very helpful in determining the prognosis for these injuries, the fracture patterns are not reliable in predicting the location of the retracted tendon end preoperatively. Therefore all flexor digitorum profundus tendon avulsions should be surgically repaired as soon as possible.