Flexor Digitorum Profundus Avulsion Injuries

FDP avulsion injuries are a type of Zone I flexor tendon injury, leaving patients unable to flex the distal interphalangeal joint. Patients with untreated injuries may experience weakened grip strength or DIP joint instability. These injuries are classified by the Leddy-Packer system, which is based on the presence and extent of bony involvement of the distal phalanx and the level of retraction of the avulsed tendon. All FDP avulsion injuries should receive early referral to a hand surgeon to facilitate prompt surgical reconstruction. Delayed initial management may prevent primary repair or decrease the likelihood of an optimal postoperative outcome. In addition to early referral and treatment, rehabilitation and therapist-directed mobilization programs are critical for optimizing outcomes. It is important to explain to patients the potential complication of stiffness and limited range of motion at the interphalangeal joints. For these injuries, patient and surgeon shared decision-making is necessary to determine the most appropriate treatment plan.