0:01

All right, so we have a 34 year old man who has pain in his poor finger.

0:07

The main finding here is involvement of the flexor mechanism.

0:11

So we're starting at the metacarpal region approximately,

0:15

and we can see the flexor digital superfic and flexor

0:20

digitorum profundus tendons.

0:23

Important to note the difference in thickness and signal intensity of the

0:28

flexor digitorum profundus as compared to the other flexor tendons

0:33

seen in this image.

0:36

The flexor digitorum profundus for the four finger is lytic.

0:41

It has this longitudinal split tier.

0:44

You can see them going all the way through the substance of the tendon.

0:49

And as we move distally,

0:51

we are going to see how the tendon starts to get more and more

0:56

teed out, and then it just disappears right there.

1:00

So we are here at the level of the proximal phalangeal neck,

1:05

and there is complete lack of visualization of the tendon from that point on.

1:10

This patient has a tear of the flexor deum profundus.

1:15

It's located at the level of the distal insertion into the

1:20

uh, palmer plate of the distal feelings. In this location,

1:25

we see a small residual tendon stump,

1:28

and then the proximal st stump is retracted all the way down to the

1:33

proximal feelings.

1:34

A calculated gap was about eight to nine centimeters.

1:40

Very important when we sit here of the flexor tendons, in this case,

1:44

the flexor profundus to assess for associated injury to the

1:49

pull mechanism. So in this patient,

1:52

the A one pulley was completely normal.

1:56

The A two pulley has some edema, but it's not disrupted.

2:00

And as we move on in the region of the A three and four pullis,

2:05

we can see how there is complete disruption of the A three and four

2:10

pullis as compared to the adjacent middle finger.

2:14

So in summary,

2:16

the diagnosis on this patient is a full thickness retracted tear

2:21

of the flexor digitorum profundus associated with injury to the

2:26

flexor pulley.