I don’t know the details of the injury or site of pain…this is referred by an orthopedist who "specializes" in personal injury cases
I am showing the normal index and middle finger, labeling the intact volar plate and checkrein ligament (which originates from the periosteum of the proximal phalanx and the level of the A2/C1 pulleys and insert onto the proximal margin of the volar plate)
There is a clear tear at the Volar plate insertion of the checkrein ligament, with fluid in the defect and slightly bright signal thickening of the chronically torn ligament (red arrows)
I have read that these ligaments are released for treatment of Dupuytren’s contracture
Obviously there is ring finger pain, and I don’t see other pathology to explain pain in that finger…..is this surgical?
Do you know?
Also, the interval between the volar cortex of the Ring proximal phalanx is 2mm at most
It measures 1.3mm in the middle finger and 2.4 mm in the index, which are uninjured
But only the index finger is flexed.
At the level of the midshaft proximal phalanx the ring A2 pulley is intact…I think there might be a partial tear at the distal medial insertion.
What do you think?
Thanks
Hilary
