case_images: PMC4765334_01
case_images: Deep, defiled and circumferential wound interesting Zone III and the ulnar border of the right hand associated to an open distal interphalangeal joint dislocation of the 5th finger
case_images: PAMJ-22-266-g001.jpg
case_images: PMC4765334_01_PAMJ-22-266-g001.jpg
case_images: F0001
case_images: General exam at admission in emergency department showed stable hemodynamic status; right hand examination objectified deep, defiled, and circumferential wound interesting Zone III and the ulnar border, there was no fractures but open distal interphalangeal joint dislocation of the 5th finger; flexor tendons were intact in this zone, but abnormally wrapped; flexion of the 2nd and 3rd fingers was impossible; neuro-vascular exam showed digital hypoesthesia without pulp ischemia (Figure 1).
case_images: Radiograph of the right hand showing distal interphalangeal joint dislocation of the 5th finger
case_images: PAMJ-22-266-g002.jpg
case_images: PMC4765334_01_PAMJ-22-266-g002.jpg
case_images: F0002
case_images: Radiograph of the right hand showed distal interphalangeal joint dislocation of the 5th finger (Figure 2).
case_images: Surgical view of the right hand showing laceration of the 2nd and 3rd flexor tendons, after extensive debridement of non-viable tissue, abundant lavage and removal of foreign body
case_images: PAMJ-22-266-g003.jpg
case_images: PMC4765334_01_PAMJ-22-266-g003.jpg
case_images: F0003
case_images: After tetanus serum injection, the patient was transferred to the operating room, where hemostasis was addressed with electrocautery, concurrently with extensive debridement of non-viable tissue and abundant lavage with removal of foreign body (Figure 3).
case_images: Flexor tendons repair with modified Kessler sutures in musculo-tendinous junction
case_images: PAMJ-22-266-g004.jpg
case_images: PMC4765334_01_PAMJ-22-266-g004.jpg
case_images: F0004
case_images: We realized anterior approach of the distal forearm, followed by modified Kessler sutures using PDS 4.0 of the sectioned tendons (Figure 4).
case_images: Restoration of finger flexion
case_images: PAMJ-22-266-g005.jpg
case_images: PMC4765334_01_PAMJ-22-266-g005.jpg
case_images: F0005
case_images: After 3 month, follow-up showed interesting results; apart from keloid palmar scar and 5th finger retraction, functional hand was restored without any infection stigmata (Figure 5, Figure 6).
case_images: Restoration of functional right hand
case_images: PAMJ-22-266-g006.jpg
case_images: PMC4765334_01_PAMJ-22-266-g006.jpg
case_images: F0006
case_images: After 3 month, follow-up showed interesting results; apart from keloid palmar scar and 5th finger retraction, functional hand was restored without any infection stigmata (Figure 5, Figure 6).