Complex lesion of the third metacarpophalangeal joint: complete tear of the radial collateral and deep transverse metacarpal ligament.

Injuries of collateral ligaments of MCPs joints are often underdiagnosed but have to be considered serious traumas of the hand. In many cases they concern thumb and rarely long fingers. Closed rupture of the deep transverse metacarpal ligament (DTML) is an unusual parallel injury. Both lesions present similar symptoms included local pain, swelling, ecchymosis and deviation of the finger in flexion and can be misdiagnosed. We describe the treatment of a 34 years old woman who sustained a complex lesion of the soft tissues of third metacarpophalangeal joint with complete close tear of the radial collateral and deep transverse metacarpal ligament following a fall during a walk thus leading to a multiplanar instability. Surgery consisted in mini anchor repair or the collateral ligament tear, direct resorbable suture of DTML and a double k-wire stabilization. Follow up at 11 months has shown excellent functional outcomes.

Pectoralis major tendon rupture in a weight lifter: a rare case.

Pectoralis major tendon (PMT) rupture is a rare event, and it was originally described by Patisser in 1822. The PMT is a thick lamina, which has two origins, one from the clavicle and the other from the ribcage sternum. PMT lesions are classified according to 3 levels of severity: Type 1 is contusions and strains, Type 2 is a partial tear and Type 3 is a complete tear. Diagnosis is made through a clinical examination which comprises a positive response to pain upon pressure over the axilla recess, the presence of bruising and limited motion, and is completed with an MRI. Type 3 injuries are treated exclusively through surgery, while Type 1 and 2 lesions are treated conservatively. In this article, we describe a rare case of PMT rupture in a 39-year-old weight lifter, the surgical treatment that was carried out through an open access at the Pectoralis and Deltoid junction and anchor suture, the post-surgical rehabilitation program and a 1-year follow-up assessment at which point return to sport was achieved.