Cho Chul-Hyun, Lee Si-Wuk
Department of Orthopaedic Surgery, Dongsan Medical Center, School of Medicine, Keimyung University, 56, Dalseong-ro, Jung-gu, Daegu 700-712, South Korea.
J Med Case Rep. 2013 Dec 30;7:281. doi: 10.1186/1752-1947-7-281.
Although spontaneous extensor tendon rupture often occurs in association with rheumatoid arthritis, extensor tendon rupture associated with osteoarthritis of the distal radioulnar joint has been rarely reported.
We present the case of a 74-year-old Asian woman with a fourth and fifth extensor tendon rupture caused by instability of the ulnar head associated with an osteoarthritic distal radioulnar joint. Intraoperative findings showed that the cause of the dorsal capsular perforation and extensor tendon rupture was mechanical friction with the unstable ulnar head, which had no osteophytes or roughness. After tendon transfer and resection of the ulnar head, our patient can extend her ring and little fingers without difficulty for her daily activities.
When a patient with osteoarthritic distal radioulnar joint has instability of the ulnar head and the 'scallop sign' on radiography, physicians should consider the possibility of extensor tendon rupture as a complication.
虽然自发性伸肌腱断裂常与类风湿性关节炎相关，但与尺桡远侧关节骨关节炎相关的伸肌腱断裂鲜有报道。
我们报告一例74岁亚洲女性病例，其第四和第五伸肌腱因与尺桡远侧关节骨关节炎相关的尺骨头不稳而断裂。术中发现，背侧关节囊穿孔和伸肌腱断裂的原因是与无骨赘或粗糙的不稳定尺骨头发生机械摩擦。经过肌腱转移和尺骨头切除术后，我们的患者能够轻松伸展环指和小指以进行日常活动。
当患有尺桡远侧关节骨关节炎的患者出现尺骨头不稳且X线片上有“扇贝征”时，医生应考虑伸肌腱断裂作为并发症的可能性。
