Avulsion of the profundus tendon insertion in athletes

A review of 36 avulsions of the flexor profundus tendon insertion in athletes seen during the past 5 years showed the injury to be most common in the ring finger. The injury was classified into three types depending upon (1) the presence or absence of a bony fragment on roentgenograms, (2) the level to which the tendon retracted, and (3) the status of the blood supply of the avulsed tendon. If the tendon retracts into the palm at the time of injury, it should be repaired within 7 days. If the tendon retracts only to the proximal interphalangeal joint, it often can be repaired a few months after the injury. Late untreated patients who were relatively asymptomatic were left alone. Those with unstable distal interphalangeal joints were treated by fusion or tenodesis of the distal joint. A flexor tendon graft through an intact functioning superficialis tendon in the ring finger seldom was indicated. Prompt diagnosis and surgical repair within the first week gave the best results.