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Fixation of a Type 3 Flexor Digitorum Avulsion Injury

Weber, Morgan B. MD*,†; Chepla, Kyle J. MD; Bafus, Blaine T. MD

Techniques in Hand & Upper Extremity Surgery: December 2019 - Volume 23 - Issue 4 - p 160–164
doi: 10.1097/BTH.0000000000000245

This article describes a novel technique for flexor digitorum profundus (FDP) avulsion injuries, useful for Leddy Packer type 3, 4, and 5 injuries. Multidirectional stability is achieved with combination pull-out suture, which neutralizes the deforming force of FDP, and cerclage wire, which holds the bone fragment in an anatomic position and provides interfragmentary compression. Traditional techniques such as interosseous wires, Kirschner wires, or plating risk fragment comminution and loss of reduction due to proximal pull of FDP as demonstrated in this case report of failed Kirschner-wire fixation. The technique presented here eliminates the risk of avulsion fragment comminution and provides stable fixation that allows for early mobilization.

*Department of Orthopaedic Surgery, University Hospitals

Departments of Orthopaedic Surgery

Plastic Surgery, MetroHealth Medical Center, Cleveland, OH

Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding.

Address correspondence and reprint requests to Blaine T. Bafus, MD, Department of Orthopaedic Surgery, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109. E-mail:

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