A 55-year-old right-handed male presented acutely with inability to flex at the distal interphalangeal (DIP) joint of the right small finger after feeling a pop while moving heavy furniture. Avulsion of the flexor digitorum profundus (FDP) tendon at its insertion, or "jersey finger," was suspected. During operative exploration, the insertion on the distal phalanx was intact, and the rupture was noted proximally at the level of the lumbrical origin. There are cases in the literature describing attritional ruptures of the tendon proximally due to metacarpophalangeal or intercarpal arthrosis, but this is the first case of a closed, proximal tendon rupture due solely to trauma. Imaging may be helpful to diagnose the level of tendon rupture. We propose surgeons perform an A1 pulley incision to determine the level of rupture prior to planning the surgical exposure for tendon repair.
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