Steroid Injection-Related Iatrogenic Rupture of Flexor Pollicis Longus Tendon-Case Report and Review of Literature

Abstract

Background:Local injection of long-acting corticosteroid solution is an easy and common treatment for tendinopathies. It may result in tendon rupture due to repeated direct injuries or chronic debility with tendon ischemia and decrease of mechanical strength.Aim and objectives:We report a case of rupture of the FPL tendon after corticosteroid injection for chronic wrist pain. A literature review of possible mechanisms and current treatments of spontaneous tendon rupture are discussed.Materials and Methods:A 60-year-old male presented to our hospital with disability of flexion over Inter-Phalangeal Joint (IPJ) of left thumb for three weeks after corticosteroid injection. We harvested ipsilateral palmar longus (PL) tendon graft for reconstruction of the FPL tendon.Results:The postoperative course was uneventful. One month later, the patient was satisfied with pain relief and the IPJ of left thumb can actively flex to 50 degree.Conclusion:We suggested that the diagnosis of tendon rupture should be considered in any patient who presents with pain and has previous local steroid injection. The patient could lead a satisfactory result without further events with early awareness of the disease and timely surgical management by direct repair, tendon grafting or tendon transfer. (J Taiwan Soc of Plast Surg 2011; 20: 324∼329)