Saturday, October 11, 2008

Profundus Laceration

The word "laceration" comes from the latin "laceratio", Latin for "tearing, lacerating". Fingers are often cut:

Photo by amanky
These injuries are often treated in the emergency room, as described by in this blog entry by an an ER doc in Texas. Worth reading....

Finger lacerations are often superficial, but a deep injury can transect a tendon. In this case, a thirty-two year old female lacerated her ring finger on a food preparation machine, and presented to a hand surgeon. The clinical examination was difficult, and the patient was referred for an MRI to better delineate the nature of the flexor tendon injury.

Sagittal gradient-recalled echo image:

The flexor digitorum profundus tendon is completely cut, with a 7 mm gap (red arrow) in the distal tendon. Interestingly, there is a second gap in the tendon (yellow arrow), just proximal to its insertion. Thus, there are two separate lacerations of the tendon, with a free-floating segment. These findings were confirmed at surgery. At surgery, it was discovered that the volar plate of the PIP joint was also cut.

Compare this to a normal flexor digitorum profundus tendon:

Lacerations usually are not referred for MR imaging, but when the clinical exam is difficult or confusing, a high-resolution MRI can often yield valuable pre-operative information.

Vic David MD

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