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Journal of Hand Surgery (European Volume)
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Articles

Closed Rupture of the Flexor Tendons Caused by Carpal Bone and Joint Disorders

H. YAMAZAKI
H. KATO
Y. HATA
Y. NAKATSUCHI
A. TSUCHIKANE

From the Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto City, Nagano, Japan, the Department of Orthopaedic Surgery, National Nagano Hospital, Ueda City, Nagano, Japan and the Department of Orthopaedic Surgery, Showainan General Hospital, Komagane City, Nagano, Japan

Correspondence: Dr Hiroshi Yamazaki, MD, Department of Orthopaedic Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto City, Nagano 390 0304, Japan. Tel.: +81 263 37 2659; fax: +81 263 35 8844. E-mail:h-ymzk{at}hsp.md.shinshu-u.ac.jp

We analysed 21 patients with closed rupture of the flexor tendons caused by carpal bone and joint disorders. The tendon that ruptured depended on the location of the bone perforation into the carpal tunnel. Radiocarpal arthrography was performed in 13 patients and capsular perforation was demonstrated by contrast medium leakage into the carpal canal in 11 patients. This proved a useful diagnostic test. The flexor tendon(s) were reconstructed with free tendon graft in 17 patients, crossover transfer of flexor tendons from adjacent digits in two and buddying to an adjacent flexor tendon in one patient. Postoperative total active range of motion in the fingers after 13 free tendon graft reconstructions averaged 213° (range 170–265°). The active range of motion of the thumb-interphalangeal joint after free tendon graft reconstruction in three cases improved from 0° to 33° on average (range 10°–40°).

Key Words: wrist • arthrography • flexor tendon • closed rupture • tendon graft

Journal of Hand Surgery (European Volume), Vol. 32, No. 6, 649-653 (2007)
DOI: 10.1016/J.JHSE.2007.06.014
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