Neglected flexor tendon injury for 10 years, un-usual finding and one stage repair without free tendon graft: Case report

INTRODUCTION: In delayed or neglected cases of flexor tendon injury, reconstruction of flexor digitorum profundus (FDP) is usually performed using free tendon graft due to the retraction of tendon ends and shortening of the tendon. Flexor digitorum superficialis (FDS), palmaris longus or plantaris tendons can be used as a free tendon graft [1–3]. PRESENTATION OF CASE: This is a case report of female patient 17 years old with neglected cut of her left Ring finger's FDP and FDS tendons zone II with suspected concomitant digital nerve injury, the injury was neglected for 10 years in the patient's non-dominant hand. DISCUSSION: Upon exploration unusual finding of spontaneous healing of the proximal stumps of FDS and FDP tendons raised the idea of doing the repair one stage without free graft by using pedicled intra-synovial graft from the sublimis tendon to reconstruct the FDP tendon. The patient after 4 months follow-up and after completion of the physiotherapy program regained the ability to actively flex her finger to near full flexion with improved function and cosmesis. CONCLUSION: Delayed flexor tendon reconstruction in neglected cases is still offering good results even after long periods of delay provided that the finger's joints are still supple and mobile.