Hung Jui-Yuan, Wang Shyu-Jye, Wu Shing-Sheng
Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Arch Orthop Trauma Surg. 2005 May;125(4):281-4. doi: 10.1007/s00402-004-0670-9. Epub 2004 Jun 15.
Spontaneous rupture of the extensor pollicis longus (EPL) tendon has been reported in the literature. Various mechanisms have been proposed to account for this problem, but gouty infiltration is a rare mechanism. Here we report a patient with a long-standing history of gout who presented with sudden loss of interphalangeal extension of the left thumb. Spontaneous rupture of the EPL tendon caused by gout was discovered.
The successful treatment done involved surgical exploration and extensor indicis proprius tendon transfer. Postoperative thumb spica immobilization for 6 weeks was applied.
Pathology disclosed urate crystals deposited within the ruptured EPL tendon. The functional recovery is satisfactory at the 1-year follow-up.
Spontaneous rupture of the EPL tendon caused by gout is rare. Successful treatment was done with surgical management. Life-long medical follow-up to prevent a repeated acute attack can lower the risk of a large amount of tophaceous gout infiltration in tendons and may possibly prevent acute spontaneous tendon rupture.
文献中已报道过拇长伸肌腱（EPL）自发性断裂。已提出多种机制来解释这一问题，但痛风性浸润是一种罕见的机制。在此，我们报告一名有长期痛风病史的患者，其出现左拇指指间关节伸展突然丧失。发现是由痛风引起的EPL肌腱自发性断裂。
成功的治疗包括手术探查和示指固有伸肌腱转移。术后拇指人字形固定6周。
病理检查显示尿酸盐结晶沉积在断裂的EPL肌腱内。1年随访时功能恢复令人满意。
痛风引起的EPL肌腱自发性断裂罕见。通过手术治疗取得了成功。进行终身医学随访以预防再次急性发作，可降低肌腱中大量痛风石浸润的风险，并可能预防急性自发性肌腱断裂。
