Otayek Salma, Pierrart Jérôme, Masmejean Emmanuel H
Department of Hand, Upper Limb and Peripheral Nerve Surgery. European Georges, Pompidou Hospital (HEGP) AP-HP, Paris, France.
Department of Hand, Upper Limb and Peripheral Nerve Surgery. European Georges, Pompidou Hospital (HEGP) AP-HP, Paris, France; Faculty of Medicine, René Descartes. Paris, France.
J Orthop Case Rep. 2016 Jul-Aug;6(3):88-90. doi: 10.13107/jocr.2250-0685.528.
The Percutaneous Needle Aponeurotomy (PNA) is a known and validated non-surgical treatment for Dupuytren's disease with a low rate of complications. Initially described for purely palmar forms, the indications extended to digital adhesions. Numerous surgeons remain hesitant about performing the PNA for digital treatment because of the risk of lesions in the noble structures. In literature, one complication is still rare, even non-existent, i.e. the tendon rupture.
We are reporting here the case of a rupture of the deep common flexor tendon, secondary to a needle aponeurotomy, for a recurring digital form in a 72-year-old woman. We performed surgical treatment by tenodesis of the distal stump and resection of the proximal stump. The result was satisfactory.
The purpose of describing this case is to report this rare complication leading to surgical revision. Within our team, we do not recommend performing PNAs for digital cases, and even less so for recurrences. For those who wish to perform the PNA, they need to know some technical artifices that enable these complications to be reduced, albeit not eliminated.
经皮针状腱膜切开术（PNA）是一种已知且经过验证的治疗掌腱膜挛缩症的非手术方法，并发症发生率较低。最初该方法仅用于单纯手掌型病例，其适应证后来扩展到手指粘连。由于存在损伤重要结构的风险，许多外科医生对于进行手指部位的PNA治疗仍持犹豫态度。在文献中，一种并发症仍然罕见，甚至不存在，即肌腱断裂。
我们在此报告一名72岁女性因复发性手指型掌腱膜挛缩症，在接受针状腱膜切开术后发生深指屈肌腱断裂的病例。我们通过远端残端腱固定术和近端残端切除术进行了手术治疗。结果令人满意。
描述该病例的目的是报告这种导致手术翻修的罕见并发症。在我们团队中，我们不建议对手指病例进行PNA治疗，对于复发病例更是如此。对于那些希望进行PNA治疗的人，他们需要了解一些技术技巧，这些技巧虽不能消除但能减少这些并发症的发生。
