Closed Zone V Injuries

Clinical presentation

Closed zone V injuries in this area may also present as a subluxation or dislocation of the extensor hood. The tendon usually subluxes in an ulnar direction, due to a tearing of the sagittal fibres on the radial side, with the middle (long) finger being the most commonly affected [21].

The injury is of forced flexion or extension at the MCPJ, with immediate pain and a persistent loss of extension of the affected finger. There may be a painful popping sensation over the dorsum of the hand with attempts at movement. Active extension of the MCPJ is weak or absent. However, once passively corrected, with the tendon having relocated centrally, the patient will be able to maintain extension actively.

Clinical management

Hand surgeon referral is required as both surgical repair and conservative management with splintage are possible.