Acute Laceration of Flexor Tendons

Mark S. Rekant

History and Clinical Presentation

A 38-year-old right hand dominant musician presents to the office 4 days following a laceration to the volar surface of his right long finger sustained after a fall onto a broken piece of glass (Fig. 33-1). He complained of pain in the right long digit with inability to actively flex his finger. He also noted decreased sensation along the ulnar aspect of his finger. He had been working prior to the accident and wished to return to playing guitar as soon as possible. He denied any past medical history but did admit to smoking one pack of cigarettes per day.

He had been seen previously at a local emergency room where his laceration was irrigated and loosely sutured. Tetanus booster and a dose of intravenous antibiotics were administered. He was discharged with a protective finger splint.

Physical Examination

An oblique volar laceration was noted, beginning radially just proximal to the proximal interphalangeal joint extending ulnarly and distally 1 cm to the midaxial line of the right long finger. The patient demonstrated no active flexion of the proximal interphalangeal (PIP) or distal interphalangeal (DIP) joints. His two-point discrimination was greater than 15 mm along the ulnar border of that digit. The digit was warm, and had good color, turgor, and normal capillary refill.

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