Article
Fixed Flexion Deformity of the Middle and Ring Fingers in Adult Caused by Intramuscular Hemangioma of the Forearm
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Published: | February 6, 2020 |
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Objectives/Interrogation: Intramuscular hemangioma (IMH) of the upper extremity is extremely rare and mostly found in children. Due to its varying clinical presentations, IMH could be unrecognized. The author presents an unusual case of fixed flexion deformity of middle and ring finger in adult that was treated by surgical excision and post-operative outcomes.
Methods: The author described a 39-year-old female who presented with middle and ring finger flexion deformity that was unable to perform active and passive proximal interphalangeal (PIP) joint extension with deep forearm pain on the volar side for 3 years. After complete evaluation, the patient was diagnosed with IMH of flexor digitorum superficialis (FDS) muscle. Excision of the IMH was performed, intra-operatively passive extension of PIP joints was achieved. After 3 months follow up, no recurrence was observed and the patient regained full hand function. The patient was satisfied with the outcome.
Results and Conclusions: IMH of the upper extremity is an uncommon disease especially in adults. With vague clinical presentations, patients with finger flexion deformity and deep pain of the forearm, IMH should be one of the differential diagnosis. Early investigation should be performed and surgical removal remains the treatment of choice. Furthermore, tendon transfer should be reserved in case of functional deficits.