The Pediatric Second Dorsal Interossei Avulsion: A Case Report and Review of the Literature

Proximal phalanx fractures are the most common hand fractures in pediatric patients, often resulting from recreational sports. Management is typically nonoperative. Avulsion fractures of the proximal phalanx are rare and invariably involve attachments of the joint capsule or collateral ligaments. Avulsions involving interosseous tendons are exceedingly rare. We report a case of a 14-year-old boy who sustained a traumatic sports injury resulting in an avulsion fracture of the second dorsal interosseous muscle at the proximal phalanx of the long finger. The patient underwent open reduction and internal fixation using a single 0.062 Kirschner wire and was subsequently immobilized in a cast for 5 weeks. Following cast and wire removal, he began independent range of motion exercises at home and regained full active range of motion 8 weeks postoperatively without formal physical therapy. To our knowledge, this is the first reported case of a second dorsal interosseous avulsion fracture successfully treated with surgical intervention.