Spontaneous rupture of the flexor digitorum superficialis tendon of the index and middle fingers: “The pen sign”

Unusual rupture of the middle finger flexor digitorum superficialis tendon in a climber: Biomechanical analysis

Sport climbing is increasingly popular and consultations by climbers in hand surgery departments are on the increase. The pathologies related to this sport concern essentially the pulley system, tendons being rarely affected. We report the case of a male climber who presented an atypical rupture of the flexor superficialis tendon in his left middle finger sustained when using an atypical climbing grip technique: the "hook grip". This consists in extension of the metacarpophalangeal joints and maximal flexion of the proximal interphalangeal joints with force exerted only on middle phalanx of the middle finger. A biomechanical analysis using finger musculoskeletal modeling was performed to compare the hook grip to other grips, and the patient's recovery performance was assessed. Adapted functional treatment with physiotherapy seems to have been a good option for the treatment of this atypical lesion since the patient recovered normal use of his finger in daily life. He recovered maximal force in climbing holds. The biomechanical analysis confirmed that the atypical "hook grip" was likely at the origin of the rupture, since flexor digitorum superficialis tendon force for this grip is greater than in other climbing grip techniques. The "hook grip" seems to be dangerous and should be used cautiously by climbers to prevent similar pathology. Additionally, the patient should henceforth be careful when climbing, since the biomechanical model showed that the remaining flexor digitorum profundus tendon was overused.

Spontaneous rupture of the flexor superficialis tendon of ring finger: a case report and review of literature

Compared with flexor digitorum profundus (FDP) tendon injury, the isolated rupture of flexor digitorum superficialis (FDS) tendon in a finger is a rare report in the literature. The pathogenesis is still unclear if we consider only tendon rupture without congenital anomalies or other diseases. The diagnosis is clinical, but it can be confirmed by ecography or magnetic resonance imaging (MRI). We report the case of a flexor superficialis (FS) tendon closed rupture of the ring finger of right hand in a 57-year-old patient. The diagnosis was confirmed by MRI. No surgical repair was used, given the limited clinical repercussions.