Chahal Jaskarndip, Dhotar Herman S, Anastakis Dimitri J
University Health Network-Toronto Western Hospital, 399 Bathurst St., EW2, Toronto, Ontario M5T 2S8, Canada.
Hand (N Y). 2009 Sep;4(3):335-8. doi: 10.1007/s11552-009-9178-7. Epub 2009 Mar 4.
A rare previously unreported cause of flexor tendon rupture is described. A 66-year-old man presented with a fully extended left middle finger, accompanied by swelling and purulent drainage. Prior to presentation, he had received a steroid injection for left middle finger stenosing tenosynovitis and subsequently developed culture-proven phaeohyphomycosis fungal infection and secondary enterococcal bacterial infection, requiring pharmacotherapy and incision, drainage, and debridement for abscess formation. Clinical and magnetic resonance imaging findings were consistent with the diagnosis of closed flexor tendon rupture of the left middle finger. Antifungal and antibiotic therapy followed by two-stage flexor tendon reconstruction was performed. Six months postoperatively, full passive range of motion was achieved and the proximal interphalangeal and distal interphalangeal joints of the left middle finger actively flexed to 125 degrees and 90 degrees, respectively.
本文描述了一种罕见的、此前未报道过的屈指肌腱断裂病因。一名66岁男性患者，左手中指完全伸直，伴有肿胀及脓性分泌物。就诊前，他因左手中指狭窄性腱鞘炎接受了类固醇注射，随后发生了经培养证实的暗色丝孢霉菌真菌感染及继发性肠球菌细菌感染，因脓肿形成而需要药物治疗以及切开引流和清创术。临床及磁共振成像结果与左手中指闭合性屈指肌腱断裂的诊断相符。给予抗真菌及抗生素治疗，随后进行了两期屈指肌腱重建术。术后6个月，实现了完全被动活动范围，左手中指近端指间关节和远端指间关节分别主动屈曲至125度和90度。
