Multi level Injury from High-energy Trauma in Sports: Case Report

Objective: Verify the efficacy of rehabilitative treatment according with splinting and early mobilization on a patient with joint and tendon injury after sport activity. Methods: The patient is a 39 years old caucasian man, he arrived at the emergency department for high-impact trauma during sport activity. The diagnosis was avulsion of the volar plate at the proximal phalanx and extensor tendon rupture at the distal phalanx. The surgical approach has been reinsertion of the volar plate at the base of the middle phalanx with 2 micromyteck anchors and extensor tendon tenorrafy after stabilization with transarticular Kirschner wire. He was subsequently subjected to early and protected mobilization program. The patient was assessed with the PRWHE, VAS and ROM every 7 days after surgery. Results: The results obtained following the setted clinical protocol are encouraging for the VAS, that improved from 8 to 2 points from the first to the last evaluation. Also the PRHWE index gave excellent results going from an initial value of 88/100 to a ending value of 3/100. Conclusions: The patient reached an excellent recovery of flexion-extension of the proximal interphalangeal joint and distal interphalangeal joint, he reintegrated gesture and functionality of the finger and hand in ADL and sport activities, thanks to an early mobilization protocol and to a continuous adaptation of the splinting.