Department of Orthopaedics, Penn State College of Medicine, State College, PA, USA.
Department of Family Medicine, Louisiana State University Health Shreveport, Shreveport, LA, USA.
Phys Sportsmed. 2022 Dec;50(6):553-556. doi: 10.1080/00913847.2022.2093619. Epub 2022 Jun 30.
Spontaneous rupture of the extensor pollicis longus (EPL) tendon at the wrist has been reported with predisposing factors to include distal radius fractures, rheumatoid arthritis, systemic or local steroids, and repetitive abnormal motion of the wrist joint.We present a case of an 18-year-old college lacrosse player without history of known predisposing factors who presented with an acute inability to extend the interphalangeal (IP) joint of his right thumb. Preoperative musculoskeletal ultrasound demonstrated rupture of the EPL tendon proximal to the carpometacarpal (CMC) joint of the thumb. A tendon transfer was therefore performed, where the extensor indicis proprius (EIP) was surgically rerouted to reconstruct the ruptured EPL. The athlete eventually returned to competition without sequela.We suggest that the tendon rupture was secondary to repetitive stick checking during play, causing microtrauma to his exposed dorsal wrist. Lacrosse team physicians, athletic trainers, and equipment managers should be aware of this injury mechanism and ensure that their players, and attackmen in particular, are equipped with gloves which adequately pad the dorsal wrist to decrease the risk of microtrauma to the EPL tendon.
伸肌肌腱在腕部的自发性断裂（EPL）已有报道，其易患因素包括桡骨远端骨折、类风湿关节炎、全身性或局部类固醇和腕关节的反复异常运动。我们报告了一例 18 岁的大学生曲棍球运动员，无已知易患因素，表现为右手拇指指间关节突然无法伸展。术前肌骨超声显示 EPL 肌腱在拇指的腕掌（CMC）关节近端断裂。因此进行了肌腱转移，将固有伸指肌（EIP）手术重新布线以重建断裂的 EPL。该运动员最终无后遗症重返比赛。我们认为肌腱断裂是由于在比赛中反复进行球杆检查，导致其暴露的背侧腕部受到微创伤。曲棍球队医生、运动训练师和设备管理人员应注意这种损伤机制，并确保他们的运动员，特别是攻击手，配备有足够垫在背侧腕部的手套，以降低 EPL 肌腱微创伤的风险。
