Best Practice Case Studies-Case 128 Asset 6 Ultrasound Evaluation of Mallet Finger

Video Transcription

Video Summary

The presentation covered a detailed ultrasound evaluation of a 34-year-old man with a mallet finger injury sustained while playing flag football. The speaker reviewed the clinical exam, prior X-rays showing a subtle avulsion fracture at the distal phalanx, and then walked through a complete digit ultrasound protocol. Key scanning points included dorsal, volar, and joint assessment using a high-frequency linear probe, with emphasis on the extensor tendon, sagittal bands, central slip, terminal tendon, and nearby joints.<br /><br />Ultrasound findings showed thickening and hypoechogenicity of the terminal extensor tendon with an avulsed bony fragment and about 8 mm dorsal proximal displacement, consistent with a bony mallet injury. There was no tendon discontinuity proximal to the DIP joint, and Doppler showed no hyperemia. The volar structures, including flexor tendons, pulleys, and volar plates, were normal. The speaker also discussed technique tips such as using lots of gel, towel wedges for finger positioning, and dynamic scanning.<br /><br />The discussion highlighted ultrasound’s value as an extension of the physical exam, especially for finger injuries and for assessing central slip integrity in PIP injuries. The session concluded that a structured protocol helps avoid missing important pathology and that modern high-frequency probes now allow highly detailed hand imaging.

Meta Tag

Edition 4th Edition

Related Case 4th Edition, Case 128

Topic Hand

Keywords

4th Edition

4th Edition, Case 128

Hand

ultrasound

mallet finger

bony avulsion fracture

extensor tendon

high-frequency linear probe

digit imaging

hand injury evaluation