Closed Extensor Indicis Proprius Tendon Rupture Presenting Mass Clinic on Dorsal Side of the Wrist

Abstract

A 28 years old male constructor referred to our clinic for a mass on the dorsal side of the left wrist. He has constricted his hand to the plaster cast machine in hyperflexion posture one month ago and swelling complaint has begun one week ago. MRI revealed tenosynovitis. A wide organized hematoma was appeared in the 4th extensor compartment in the surgical exploration of the patient and it was observed that extensor indicis proprius tendon has detached from the musculotendineous region. Common extensor tendon of the second finger was intact. Tenodesis to the distal end of the ruptured tendon to the intact common extensor tendon by side to side surgical suture technique was performed. There were complete extension in the 2nd finger at the 2nd month after the surgery.

Keywords

• Closed tendon rupture, extensor indicis proprius, musculotendineous region

Closed Extensor Indicis Proprius Tendon Rupture Presenting Mass Clinic on Dorsal Side of the Wrist

Abstract

28 yaşında erkek işçi sol el bileğinde kitle şikayeti ile kliniğimize başvurdu. Hasta 1 ay önce elini hiperfleksiyon pozisyonunda alçı karıştırma makinesine sıkıştırmış ve 1 hafta önce de şişlik şikayeti başlamış. MRG'de tenosinıvit gözlendi. 4. ekstensör kompartmanın cerrahi eksplorasyonunda geniş organize hematom ve ekstensör indicis proprius tendonunun muskulotendinöz bölgeden koptuğu görüldü. İşaret parmağı kommon ekstensör tendonunun sağlam olduğu görüldü. Kopuk olan ekstensör tendonun distal ucu yan-yana cerrahi dikiş tekniği kullanılarak sağlam olan kommon ekstensör tendona tenodez yapıldı. Ameliyat sonrası 2. ayda işaret parmağında tam ekstansiyon mevcuttu

Keywords

• Kapalı tendon rüptürü, ekstensör indicis proprius, muskulokutenöz bölge

References

1. Engkvist 0, Lundborg G. Rupture of the extensor pollicis longus tendon after fracture of the lower end of the ra- dius: a clinical and microangiographic study. Hand 1979; 11: 76-86.
2. Straub LR, Wilson EH Jr. Spontaneous rupture of extensor tendons in the hand associated with rheumatoid arthritis. J Bone Joint Surg Am 1956;38:1208–17.
3. McMaster PE. Late rupture of extensor and flexor polli- cis longus tendons following Colles' fracture. I Bone Joint Surg 1932; 14: 93-101.
4. Sadr B. Sequential rupture of extensor tendons after a Colles' fracture. I Hand Surg Am 1984; 9-A: 144-5.
5. Uchida Y, Sugioka Y. Extensor tendon rupture associated with Smith's fracture. Acta Orthop Scand 1990; 61: 374-5.
6. Itoh Y, Horiuchi Y, Takahashi M, Uchinishi K, Yabe Y. Extensor tendon involvement in Smith's and Galeazzi's fractures. I Hand Surg Am 1987; 12-A: 535-40.
7. Figure 4. Postoperative photograph showing that the
8. patient has complete movement in the 2nd finger in

9. his control after 2 months
10. Harvey FJ, Harvey PM. Three rare causes of extensor ten- don rupture. I Hand Surg Am 1989; 14-A: 957-62.
11. Gladstone H. Rupture of the -extensor digitorum commu- nis tendons following severely deforming fractures about the wrist. J.Bone Joint Surg Am1952;34-A 698-700.
12. Vaughan-Jackson OJ. Rupture of extensor tendons by at- trition at the inferior radio-ulnar joint. J Bone Joint Surg Br 1948;30:528–30.
13. Szarman A, Chen M, Blum MD. More on fluoroquinolone an- tibiotics and tendon rupture. N Engl JMed 1995;332:193.
14. Bunata RE. Impending rupture of the extensor pollicis longus tendon after a minimally displaced Colles' frac- ture. J Bone Joint Surg Am 1983; 65A: 401-2.
15. Helal B, Chen SC, Iwegbu G. Rupture of the extensor pol- licis longus tendon in undisplaced Colles' type of fracture. Hand 1982; 14: 41-7.
16. Strandell G. Post-traumatic rupture of the extensor pol- licis longus tendon; pathogenesis and treatment: survey based on 208 cases, including 14 personal cases. Acta Chirurgica Scandinavica 1955; 109: 82-96.
17. P. R. Stuart FRCS and P. J. Briggs FRCS Closed extensor tendon rupture and distal radial fracture with use of a gymnast's wrist support Br J Sp Med 1993; 27; 2, 92-3.
18. Ozalp T, Ozdemir O, Coşkunol E, Erkan S, Calli IH. Extensor indicis proprius transfers for extensor pollicis longus ruptures secondary to rheumatoid arthritis Acta Orthop Traumatol Turc 2007; 41, 48-52.