Treatment for complete extensor tendon rupture: A case report on extensor pollicis longus tendon transfer and tenodesis procedure to radius for a patient with rheumatoid arthritis.

IF 0.9 Q4 RHEUMATOLOGY Modern rheumatology case reports Pub Date : 2024-07-08 DOI:10.1093/mrcr/rxae015
Kazuhiro Kohata, Takafumi Miyake, Yutaka Morizaki, Takahiro Sasaki, Sakae Tanaka
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Abstract

The complete loss of finger extension leads to significant inconvenience in daily life and often requires surgical treatment. Despite some disadvantages, the Boyes method, which uses the flexor digitorum superficialis tendon, is commonly performed for complete extensor rupture. We report the case of a 73-year-old woman living alone diagnosed with a subcutaneous rupture of all extensor tendons from the index to the little finger. The favourable range of motion of her wrist allowed us to perform extensor tenodesis. Additionally, the patient had a dislocated thumb interphalangeal (IP) joint, enabling us to use the extensor pollicis longus tendon for tendon transfer in combination with thumb IP joint fusion. The patient demonstrated favourable finger range-of-motion outcomes at the 6-month postoperative assessment. The case shows that extensor pollicis longus tendon transfer and tenodesis may be a viable treatment option for patients with complete extensor rupture accompanied by thumb IP joint deformity and normal wrist range of motion.

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伸肌腱完全断裂的治疗:类风湿性关节炎患者伸拇肌肌腱转移和桡骨腱鞘切除术的病例报告。
手指完全丧失伸展功能会给日常生活带来极大不便,通常需要进行手术治疗。尽管存在一些缺点,但使用屈指浅肌腱的 Boyes 方法通常用于治疗伸指肌腱完全断裂。我们报告了一名 73 岁独居女性的病例,她被诊断为从食指到小指的所有伸指肌腱皮下断裂。她的手腕活动范围良好,因此我们可以对其进行伸指肌腱腱鞘切除术。此外,患者的拇指指间关节(IP)脱位,因此我们可以使用伸拇肌肌腱(EPL)进行肌腱转移,并结合拇指 IP 关节融合术。在术后 6 个月的评估中,患者的手指活动范围表现良好。该病例表明,对于伴有拇指 IP 关节畸形和腕关节活动范围正常的伸肌完全断裂患者,EPL 肌腱转移和腱鞘切除术可能是一种可行的治疗方案。
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