Nagy Mathias Thomas, Ghosh Sabyasachi, Shah Bhavik, Sankar Thangasamy
Department of Trauma and Orthopaedic Surgery, Kettering General Hospital, Kettering, UK.
BMJ Case Rep. 2014 Apr 16;2014:bcr2013010188. doi: 10.1136/bcr-2013-010188.
We report a rare case of an 84-year-old woman who presented with delayed, complete rupture of superficial (flexor digitorum superficialis) and deep flexor tendons (flexor digitorum profundus) of the third, fourth and fifth digits of the right hand in zone V of the flexor tendons. The patient, who was otherwise healthy, active and independent, incurred a closed fracture of her right wrist 18 years ago, which was treated conservatively. Current X-rays and operative findings confirmed a malunited Galeazzi fracture-dislocation with volar dislocation of the ulna from the distal radioulnar joint. She underwent surgical treatment to improve her hand function and agonising neuritis symptoms, as she was unable to use her middle, ring and little fingers and had developed severe neuritis of the ulnar nerve. Exploration and repair of the flexor tendons, nerve decompressions and Darrach procedure were performed. On follow-up, the patient showed improvement in hand function with the neuritis completely resolved.
我们报告了一例罕见病例，一名84岁女性，其右手第三、四、五指的浅屈肌腱（指浅屈肌）和深屈肌腱（指深屈肌）在屈肌腱V区出现延迟性完全断裂。该患者身体健康、活跃且独立，18年前右手腕发生闭合性骨折，当时接受了保守治疗。目前的X线检查和手术结果证实为Galeazzi骨折脱位畸形愈合，尺骨从远侧桡尺关节掌侧脱位。由于她无法使用中指、环指和小指，并出现了严重的尺神经炎症状，她接受了手术治疗以改善手部功能并缓解疼痛性神经炎症状。进行了屈肌腱探查和修复、神经减压以及Darrach手术。随访时，患者手部功能有所改善，神经炎完全消退。
