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Sagittal Band Rupture

1/18/2015

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HPI: Young male presents after feeling a pop in his finger after he dropped a case of bottled water causing his middle finger to get caught in the wrapping.  

PE:  Ulnar deviation of affected digit and a popping sensation and pain when flexing his fingers.
Picture
Picture
Imaging:
  • Hand x-rays
  • Ultrasound: Subluxation of EDC on MCP flexion
  • MRI to clarify diagnosis if unclear on physical exam
Picture
Anatomy:
  • Sagittal band is the primary stabilizer of the extensor tendon at the MCP and is a fascial tube that surrounds the metacarpal head and extensor tendon.
Treatment Options:
  • Non-operative: extension splint for 4-6 weeks
  • Operative: chronic injuries, professional athletes
Pearls:
  • Most common in pugilists (cool word for boxers!)
  • Middle finger most common
Dispo:
  • Can follow up with ortho as outpatient
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  • RESIDENCY
    • About CMC
    • Curriculum
    • Benefits
    • Explore Charlotte
    • Official Site
  • FELLOWSHIP
    • EMS
    • Global EM
    • Pediatric EM
    • Toxicology >
      • Tox Faculty
      • Tox Application
    • (All Others)
  • PEOPLE
    • Program Leadership
    • PGY-3
    • PGY-2
    • PGY-1
    • Alumni
  • STUDENTS/APPLICANTS
    • Prospective Visiting Students
    • UNC/Wake Forest Students
    • Healthcare Disparities Externship
    • Resident Mentorship
  • #FOAMed
    • EM GuideWire
    • CMC Imaging Mastery
    • Pediatric EM Morsels
    • Blogs, etc. >
      • CMC ECG Masters
      • Core Concepts
      • Cardiology Blog
      • Dr. Patel's Coding Blog
      • Global Health Blog
      • Ortho Blog
      • Pediatric Emergency Medicine
      • Tox Blog
  • Chiefs Corner
    • Top 20
    • Current Chiefs
    • Schedules >
      • Conference/Flashpoint
      • Block Schedule
      • ED Shift Schedule
      • AEC Moonlighting
      • Journal Club/OBP/Audits Schedule
      • Simulation
    • Resources >
      • Fox Reference Library
      • FlashPoint
      • Airway Lecture
      • Student Resources
      • PGY - 1
      • PGY - 2
      • PGY - 3
      • Simulation Reading
      • Resident Wellness
      • Resident Research
      • Resume Builder
    • Individualized Interactive Instruction