Spontaneous Flexor Tendon Rupture due to Primary Distal Radioulnar Joint Osteoarthritis.

Akira Hashimoto,Motoki Sonohata,Hideyuki Senba,Masaaki Mawatari

doi:10.1155/2019/7604897

Abstract

Spontaneous flexor tendon rupture is rare, occurring most commonly in the little finger or flexor pollicis longus. To the best of our knowledge, there have been no reports of spontaneous flexor tendon rupture due to primary distal radioulnar joint (DRUJ) osteoarthritis (OA). We present a case of spontaneous flexor tendon rupture in the index finger due to primary DRUJ OA in a 71-year-old female farmer. Surgical exploration confirmed that, at the wrist joint level, the flexor digitorum profundus of the index finger had undergone degeneration and complete rupture. The flexor digitorum superficialis of the index finger was elongated and thinned. A bony spur toward the volar side was covered with synovial fluid from a pinhole-sized perforation of the capsule. The combination of direct friction from the DRUJ spur and the matrix metalloproteinases in the synovial fluid from the perforation of the DRUJ capsule may have caused the spontaneous flexor tendon rupture. Palmar-side symptoms associated with DRUJ OA should be carefully examined because of the risk of spontaneous flexor tendon rupture.

Highlights

Spontaneous flexor tendon rupture is relatively uncommon and is usually caused by trauma, inflammatory disease, steroids, or surgical complications from plate, and carpal bone and joint disorders [1, 2]
There are reports of extensor tendon rupture associated with primary distal radioulnar joint (DRUJ) OA [8, 9], to the best of our knowledge, there have been no reports of spontaneous flexor tendon rupture due to primary DRUJ OA
We report a case of spontaneous flexor tendon rupture in an index finger due to primary DRUJ OA

Summary

Introduction

Spontaneous flexor tendon rupture is relatively uncommon and is usually caused by trauma, inflammatory disease, steroids (injection or oral therapy), or surgical complications from plate, and carpal bone and joint disorders [1, 2]. There have been reports of unusual causes of spontaneous flexor tendon rupture, scaphoid nonunion, hamate hook nonunion, Kienböck’s disease, dorsal intercalated segment instability, and pisotriquetral osteoarthritis (OA) [3,4,5,6,7]. There are reports of extensor tendon rupture associated with primary distal radioulnar joint (DRUJ) OA [8, 9], to the best of our knowledge, there have been no reports of spontaneous flexor tendon rupture due to primary DRUJ OA. We report a case of spontaneous flexor tendon rupture in an index finger due to primary DRUJ OA. The patient was informed that this case study would be submitted for publication, and she provided informed consent

Case Presentation

Discussion