Orthopaedic Hand Trauma CH35

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CHAPTER 35  | Jersey Finger

Flexor digitorum profundus (FDP)

Figure 35.5  Dorsal button repair. FDP, flexor digitorum profundus.

dorsal incision. For this technique, holes are drilled at a 45° angle from distal-volar to proximal-dorsal to increase the resistance to pullout of the implant. Intraoperative fluoroscopy is used to ensure that there has been no disruption of the dorsal cortex or the DIP joint. To allow for direct tendon-bone healing, the FDP must be flush with the bone. ◆ ◆ Disadvantages—This technique is less successful in patients with osteoporotic bone or avulsion fractures. It also has been associated with higher risk of contracture after the procedure. ● ● Currently, there is not enough literature to the support the use of one technique over another. Future studies are needed to make evidence-based recommendations; the surgical technique used is left to surgeon preference. ■ ■ Type III/IV/V ● ● The presence of an intact vincula systemmakes type III to V injuries more amenable to later repair. These injuries are repaired with open reduction internal fixation (ORIF) of the fracture. Various techniques have been proposed with successful results, including fixation with