Kojima Takahito, Yasuda Masataka, Hama Shunpei, Fukuda Makoto, Minato Kenta
Department of Orthopaedic Surgery, Baba Memorial Hospital, Osaka, Japan.
Case Rep Orthop. 2020 Aug 10;2020:8850427. doi: 10.1155/2020/8850427. eCollection 2020.
We report the case of a 69-year-old male patient with extensor pollicis longus (EPL) tendon rupture associated with a scaphoid nonunion advanced collapse (SNAC) wrist. He could not actively extend the left thumb interphalangeal joint and visited our institution for an examination. Plain X-rays revealed advanced stage SNAC and an enlarged soft tissue shadow owing to dorsal ridge growth. The patient was diagnosed with EPL tendon subcutaneous rupture due to SNAC. During surgery, the EPL tendon was found to be absent, a proximal-type scaphoid nonunion was detected, and bone growth to the dorsal part of the dorsal ridge was observed. Considering that the EPL tendon rupture was associated with the bone growth, we performed scaphoid lunate advanced collapse (SLAC) reconstruction and extensor indicis proprius tendon transfer which needed a revision tendon surgery afterward. To the best of our knowledge, EPL tendon ruptures caused by SLAC or SNAC are considered rare and have not yet been reported.
我们报告了一例69岁男性患者，其拇长伸肌（EPL）肌腱断裂，伴有舟骨不愈合晚期塌陷（SNAC）腕关节。他无法主动伸展左拇指指间关节，遂前来我院就诊检查。X线平片显示SNAC晚期以及由于背侧嵴生长导致的软组织阴影增大。该患者被诊断为因SNAC导致的EPL肌腱皮下断裂。手术中发现EPL肌腱缺失，检测到近端型舟骨不愈合，并观察到向背侧嵴背侧的骨生长。考虑到EPL肌腱断裂与骨生长有关，我们进行了舟月骨晚期塌陷（SLAC）重建和示指固有伸肌腱转移，术后还需要进行肌腱翻修手术。据我们所知，由SLAC或SNAC引起的EPL肌腱断裂被认为很罕见，尚未见报道。
