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CASE REPORT

Northwell Health Physician Partners Orthopaedic Institute at Huntington

Orthopaedic Surgeon - General Specialty

Northwell Health

(P: 217108) If you choose fragment reduction & fixation, how would you perform your procedure?

I would not choose operative management with fragment fixation

6/327

Open

46%

152/327

Arthroscopic

16%

53/327

Combined Open and Arthroscopic

31%

103/327

Outside my area of expertise - best if I don't vote

13/327

postop was NWB for 4 weeks. boot at 2 weeks and progressive range of motion. Fixation was rock solid.

Jan Szatkowski, MD, MBA looks great. Well planned and executed. Key to notice in the intraop X-ray the 2 wires placed in the fragment by Dr. Adam Bitterman - even when the fragment is too small for 2 screws, an additional wire help avoid fragment malreduction/rotation when placing the screw in. Be... autiful outcome!

Acute injury and I'll educate, lay the crepe, and fix. Revision, no way. I give them the "definition of insanity" line. In all seriousness, I had 2 patients successfully quit smoking using hypnosis 🫣

The bone anatomy is what I would be looking for here. Figure out orientation and more details in the dome fragment. I am not sure what MR would add

Thanks for adding me. Unusual injury. Definite indication for surgery. Seems well accessible through arthroscopy without fibular osteotomy, especially as I‘m placing bets that the ATFL is torn. Flip that fragment with a k-wire or arthroscopic clamp and fix it with Herbert-screw(s). Repair any con... current damage seen on the MRI I‘d get beforehand (talar tilt is suggestive of that). WBAT with FROM.

Flexor Tendon Injuries

PMID: 16304800 Am J Orthop (Belle Mead NJ). 2005 Oct;34(10):505-7.

Traumatic simultaneous rupture of both flexor tendons in a finger of an athlete.

ABSTRACT
- We report a case of traumatic simultaneous disruption of both finger flexor tendons in a professional athlete. The novelties in this report are (1) the location of the rupture (FDS at midsubstance and FDP at insertion) and (2) the proposition that a normal but diminutive FDS tendon is a contributing factor in the rupture. We recommend that simultaneous rupture of the normal flexor tendons be treated in a similar manner as tendon lacerations. Primary repair, if possible, is the treatment of choice in these acute injuries. Tendon grafting should be reserved for subacute or chronic cases in which restoration of active finger flexion is needed.