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Scaphoid nonunion and flexor pollicis longus tendon rupture
1Department of Orthopaedics, Shinshu University School of Medicine, Asahi, Matsumoto City, Japan.
The Journal of Hand Surgery
|December 10, 1999
Summary
Longstanding scaphoid nonunion can lead to flexor pollicis longus tendon rupture. Surgical repair involving bone grafting for the scaphoid and tendon grafting for the rupture achieved successful outcomes.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Research
Background:
- Flexor pollicis longus tendon rupture is a rare complication.
- Longstanding scaphoid nonunion can lead to wrist joint instability and degeneration.
- Associated radiocarpal arthrosis and dorsiflexed intercalated segment instability are common in these cases.
Purpose of the Study:
- To investigate the association between longstanding scaphoid nonunion and flexor pollicis longus tendon rupture.
- To evaluate the surgical management and outcomes for this combined pathology.
Main Methods:
- Case series of four patients with flexor pollicis longus tendon rupture and scaphoid nonunion.
- Surgical intervention in three patients included osteosynthesis with iliac bone graft for scaphoid nonunion and palmaris longus tendon graft for tendon rupture.
Main Results:
- All three surgically treated patients achieved osseous union of the scaphoid.
- Functional active range of motion of the thumb interphalangeal joint (average 33 degrees) was restored.
- Preoperative and intraoperative findings indicated a volarly protruding distal scaphoid segment as the likely cause of tendon rupture.
Conclusions:
- Longstanding scaphoid nonunion is a potential cause of flexor pollicis longus tendon rupture.
- Surgical treatment combining scaphoid reconstruction and tendon repair can yield favorable functional results.