Disclosures: Charl H. Woo, DO: No financial relationships or conflicts of interest

Case Diagnosis: A 32-year-old right-handed male active-duty service member with an extensor digitorum tendon laceration injury in the proximal interphalangeal (PIP) joint of right 3rd finger.

Case Description: The patient sustained a finger extensor tendon laceration, confirmed by magnetic resonance imaging (MRI), in his right 3rd PIP joint while participating in military training. He underwent occupational therapy (OT) for 6 months due to limited range of motion (ROM) at the joint, and pain and sensitivity with electric sensation to touch over the injury site. His OT provided a wide spectrum of treatments, including various table-top activities, soft tissue mobilization, fluidotherapy, and blood flow restriction. Due to suboptimal improvement, a repeat MRI was completed which also showed scar tissue formation. After local anesthesia, an autologous Plate Rich Plasma (PRP) injection was performed over the thickened extensor tendon in a lateral-to-medial plane approach under ultrasound-guidance with gentle tenotomy at an area of cortical irregularity. Although he experienced sensation of fullness in the joint post-injection the patient returned home with no post-procedural complications such as bleeding, edema, or worsening pain.

Setting: OutpatientAssessment/

Results: The patient was able to fully return to military duty without physical limitations a few days after the procedure. At 4 months post-intervention, the patient showed notable improvement in pain to touch over the injury site, with some improvement in sensitivity and ROM at the joint. No further OT was required.

Discussion: Per our literature review, this is the first reported case of a PRP injection trial for a tendon laceration injury in a small distal peripheral joint such as the finger to improve ROM at the joint, pain and sensitivity to touch over the injury site.

Conclusion: PRP injection can be an alternative approach to safely improve pain, sensitivity, and decreased ROM in a finger joint secondary to an extensor tendon laceration injury refractory to focused therapy.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-novel-approach-for-an-ultrasound-guided-platelet-rich-plasma-injection-for-an-active-duty-soldiers-extensor-tendon-injury-in-the-proximal-interphalangeal-joint-a-case-report/