Proximal phalanx flexor tendon tenodesis after severe frostbite in a rock climber

Hand Surg Rehabil. 2024 Jun;43(3):101685. doi: 10.1016/j.hansur.2024.101685. Epub 2024 Mar 21.

Abstract

A 32 year-old climber sustained a grade IV frostbite injury to the right hand which required amputation at the neck of the proximal phalanges of all the long fingers. To increase range of motion and strength in the remaining metacarpophalangeal joints, tenodesis of the flexor digitalis superficialis and profundus tendons onto the proximal phalanges was performed. Several revisions for removal of bony spurs, dorsal skin advancement flaps and web space deepening were necessary. After 2 years, the patient achieved 10-0-100° metacarpophalangeal joint range of motion in extension-flexion and could do full body-weight pull-ups on 1 cm deep holds, lift 50 kg on a 2 cm deep hold (normal contralateral side, 40 kg), climb up to F7a routes and use a mechanical 4-finger functional prosthesis.

Keywords: Finger amputation; Finger prosthesis; Proximal phalanx FDP and FDS tenodesis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Finger Injuries* / surgery
  • Finger Phalanges / injuries
  • Finger Phalanges / surgery
  • Frostbite* / surgery
  • Humans
  • Male
  • Mountaineering*
  • Range of Motion, Articular
  • Tenodesis*