The patient injured his right 5th finger while playing basketball 2 weeks prior. By the time he had presented to our department, he had advanced flexion contracture and no passive extension indicating a grade 4 deformity and the likelihood of a poor outcome.

Ultrasound showed complete rupture of the central extensor tendon slip resulted in a marked Boutonniere deformity with wide separation of the lateral slips. There was tearing of the collateral ligaments and probable rupture of the PIP palmar plate.

There was no evidence of avulsion fracture on ultrasound or X-ray.