Closed Injury of Flexor Digitorum Profundus and Superficialis Tendons of Ring Finger -- A Rare Case

The usual causes of flexor tendon injuries in hand are penetrating wounds. Closed injury and avulsion of flexor tendon are rare and mostly occur as avulsion of flexor digitorum profundus tendon of ring finger from its bony insertion at distal phalanx. Closed avulsion of flexor digitorum superficialis is even rarer. The rarest is simultaneous closed avulsion of both flexors in the same finger, only ten cases of which have been reported in the literature. Case Report: The patient of the present study was a healthy 23-year-old right-handed male farmer who had fallen down during power lifting in a body building club six weeks prior to being referred to the hospital. After this event he was unable to flex his fourth left finger through interphalangeal joints. There was no injury to the skin of his hand. Six weeks later he had full passive range of motion in interphalangeal joints of that finger without active range of motion. With the impression of closed rupture of both flexors of the ring finger, he underwent two- stage tendon graft because of contracture of pulley system. Closed injury of both flexor tendons should be considered in similar situations, though it is rarely observed.