Alsaadi Yazeed, Alhassan Turki S, Alfawzan Mohammed F, Aldekhayel Salah, Almeshal Obaid M
Department of Plastic Surgery, King Abdulaziz Medical City-Riyadh, Riyadh 11426, P.O. Box 22490, Saudi Arabia.
Department of Plastic Surgery, King Abdulaziz Medical City-Riyadh, Riyadh 11426, P.O. Box 22490, Saudi Arabia.
Int J Surg Case Rep. 2020;67:235-238. doi: 10.1016/j.ijscr.2020.01.041. Epub 2020 Feb 6.
Isolated closed rupture or avulsion of the flexor digitomm superficialis (FDS) tendon at its insertion is a rare diagnosis. It can be related to a pathology such as rheumatoid arthritis, bony abnormalities, tenosynovitis, fractures, or tuberculosis. A review of the literature identified only few cases of closed avulsion or rupture of FDS tendons nonpathologically. We hope this report will help to gather more experience for the surgical intervention in a delayed presentation of ruptured flexor digitorm superficialis tendon. The work has been reported in line with the SCARE criteria.
We report a case of 48-year-old surgeon who sustained a trauma to her left middle finger. The patient presented three months after injury with complaints of pain and decreased range of motion of involved digit. Patient was treated conservatively and after failure of conservative treatment surgical intervention was done with complete tendon excision and capsulotomy of Proximal interphalangeal joint. Patient retained full range of motion and pain subsided.
Isolated closed avulsions or rupture of the FDS tendon is a challenging entity in hand surgery in diagnosis and treatment. Nonsurgical treatment with splinting and physiotherapy might help to prevent flexion deformity. The surgical treatment include tenolysis, flexor digitorum superficialis tendon excision, and in selected patients capsulotomies of involved joints.
A review of the literature identified only few cases of closed avulsion of FDS tendons nonpathologically. Early diagnosis and intervention can prevent sequel of flexion contracture.
指浅屈肌腱(FDS)在其止点处发生孤立性闭合性断裂或撕脱是一种罕见的诊断。它可能与类风湿关节炎、骨骼异常、腱鞘炎、骨折或结核病等病理状况有关。文献回顾发现非病理性的FDS肌腱闭合性撕脱或断裂病例很少。我们希望本报告有助于为延迟出现的指浅屈肌腱断裂的手术干预积累更多经验。本研究已按照SCARE标准进行报告。
我们报告一例48岁外科医生左手环指受伤的病例。患者受伤三个月后就诊,主诉受伤手指疼痛且活动范围减小。患者先接受了保守治疗,保守治疗失败后进行了手术干预,包括完全切除肌腱和近端指间关节囊切开术。患者保留了全部活动范围,疼痛也消失了。
FDS肌腱的孤立性闭合性撕脱或断裂在手部手术的诊断和治疗中是一个具有挑战性的问题。使用夹板和物理治疗进行非手术治疗可能有助于预防屈曲畸形。手术治疗包括肌腱松解术、指浅屈肌腱切除术,以及在选定患者中对受累关节进行关节囊切开术。
文献回顾发现非病理性的FDS肌腱闭合性撕脱病例很少。早期诊断和干预可预防屈曲挛缩后遗症。