Background/Objectives: Reports on type V FDP tendon avulsions and their treatment are rare. Furthermore, they are not always classified in a consistent manner in the literature. The purpose of our retrospective data analysis was to evaluate and present jersey finger type V injury characteristics, primary radiological findings, treatment options and subsequent patient outcomes, as well as potential complications. Methods: We reviewed all patients treated for a fracture of the distal phalanx at an academic Level 1 trauma center over a period of 19 years. By reviewing the patients’ charts and their initial X-rays, we identified 44 patients with injuries matching the criteria for classification as jersey finger type Va and type Vb. All clinical records and radiologic images were reviewed to gather data on the mechanism of trauma, injury characteristics, type of treatment and subsequent outcomes in both subtypes. Results: Direct blows represented the most common mechanism of trauma, accounting for 23 cases. Among 44 jersey finger type V injuries, 31 showed minor displacement and were treated conservatively with a good outcome. Six patients undergoing surgery showed a poor outcome, except for one. Conclusions: Jersey finger type V differs considerably from the remaining types of jersey finger injuries regarding the predominant trauma mechanism. Therefore, its inclusion in this classification should be reevaluated. Established surgical techniques for refixation did not show a satisfying outcome, thus the implementation of alternative surgical techniques seems advisable when better therapeutic results are sought.

This study aimed to differentiate between the attachment sites of the volar plate and the flexor digitorum profundus (FDP) tendon by specific measurements in lateral radiographs. Furthermore, their relation to a volar spur was assessed. We dissected the attachments of the volar plate and the FDP tendon in 200 distal phalanges of male and female body donors. The margins of the attachments were marked with cannulas for subsequent radiological evaluation. The location of a not yet described volar spur at the base of the distal phalanx was assessed hypothesizing a potential correlation to the FDP tendon attachment. The analyzed phalanges were 16.8 ± 1.5 mm long and 5.6 ± 0.7 mm deep. The volar spur was identifiable in all specimens and was located 3.5 ± 0.6 mm from the volar articular line. The distances from the articular line to the volar spur and to the proximal margin of the FDP tendon showed strong correlation (0.560, p < 0.001). The proximal margin of the FDP tendon attachment was located at 47.4 % ± 10.6 % of the distance between the articular line and the volar spur. The volar spur at the volar base of the distal phalanx facilitates the identification of the FDP tendon attachment and its differentiation from the volar plate attachment. This may be essential in the characterization of bony volar plate avulsion in the distal phalanx. Furthermore, the volar spur may serve intraoperatively as radiological reference of the centroid of the FDP tendon attachment facilitating correct repair placement in FDP tendon avulsions.

Background/Objectives: The aim of this study was the investigation of any correlation between medial meniscal extrusion (MME) and T2 relaxation times. Furthermore, the impact of different meniscal morphologies on the femoral cartilage was assessed. Methods: Fifty-nine knees of fifty-five patients (twenty-four female, thirty-one male) with a mean age of 33.7 ± 9.2 years and without risk factors for MME or osteoarthritis were examined in a 3.0T MRI. MME was assessed quantitatively in accordance with BLOKS score. T2 maps were calculated from sagittal 2D MESE sequences. The region of interest was defined as the load-bearing cartilage at the medial femoral condyle and analysis was performed on two consecutive slices. T2 values were correlated to MME; furthermore, mean T2 values were compared in different grades of MME. Results: T2 values showed a strong correlation with increasing MME (r = 0.635; p < 0.001) in an exponential pattern. Analogously, knees with MME ≥ 3 mm showed statistically significant higher T2 values (p < 0.001) compared to knees with MME ≤ 2 mm and 2.1–2.9 mm; between the latter two, no differences in T2 values were found. Conclusions: T2 values showed a strong correlation with increasing MME. Consequently, MME ≥ 3 mm has a detectable impact on the cartilage of the femur.

Summary: Purpose: Subcapital fractures of the fifth metacarpal bone are one of the most common fractures of the hand. Surgical and conservative treatment is possible but the respective indications remain controversial. Closed reduction and cast retention are commonly performed for these fractures but their effectiveness in fracture retention is unclear. Therefore, the aim of this study was to evaluate the efficacy of closed reduction with consecutive below-elbow casting and finger splinting. Methods: Radiographs of 115 patients with a subcapital fracture of the fifth metacarpal bone at an academic level 1 trauma center were retrospectively reviewed and volar angulation was assessed at initial presentation, after reduction and at the end of treatment. Results: The patients mean age was 32 years (IQR 25–37 years) and 93% were male ( n = 107). Cast immobilization was 4 weeks in all cases. Volar angulation at initial presentation was 49.9° ± 11°. After reduction an angle of 40.9° ± 9.2°was observed. After cast removal, an angulation of 42.4° ± 9.9° was observed. A repeated measures ANOVA with a Huynh-Feldt correction showed that the difference in mean fracture angulation was statistically significant. Conclusion: This study indicates that improved fracture angulation can be maintained with closed reduction and retention in a below-elbow cast with finger splinting. Further studies have to be conducted to investigate whether improved fracture angulation results in more favorable clinical outcomes.