A variety of surgical treatment methods for an avulsion of the flexor digitorum profundus (FDP) from its insertion and simultaneous fracture of the volar base of the distal phalanx, the so-called type IV FDP avulsion had been reported. The need to simultaneously reattach the FDP tendon and fixate the avulsed bony fragment makes the treatment of this injury challenging. The authors described a surgical technique of repair using a pullout suture tied over an external dorsal button without the need for retained hardware.

Keywords: Avulsion, Flexor digitorum profundus, Type IV, Pullout button suture