Summary
The authors report the case of a 19-year-old female with delayed presentation of a
type II ‘jersey finger’ of the fourth dominant digit. A surgical approach was performed,
revealing a retracted flexor digitorum profundus tendon within a still patent sheath.
The resulting loss of tendon length overruled any possibility of direct reinsertion
of the tendon. A lengthening “Z-step” tendinoplasty was then performed on the tendon
at the wrist, thus enabling reinsertion at the base of the distal phalanx. The patient
then underwent conventional splinting and physiotherapy. Total Active Motion was measured
at 220° with a 6-month follow-up. Even though there is no clear consensus concerning
management of such cases, different techniques have been described, such as one- or
two-stage grafting, or tenotomy at the musculotendinous junction. Lengthening tendinoplasties
have been applied by certain authors but only to the flexor pollicis longus tendon.
To our knowledge, this is the only reported case of lengthening Z-step applied to
a long digit for the repair of type II ‘jersey finger’ lesions. The satisfactory functional
and cosmetic outcome encourages us to consider this one-stage technique in other select
cases, in order to gather more formal evidence.
Keywords
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References
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Article info
Publication history
Published online: July 20, 2011
Accepted:
June 24,
2011
Received:
July 26,
2010
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
