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Pisotriquetral instability causing an unusual flexor tendon rupture
Eveline M L Corten1, Duco G van den Broecke, Moshe Kon
1Department of Plastic, Reconstructive and Hand Surgery, University Medical Center, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
The Journal of Hand Surgery
|March 27, 2004
Summary
A small finger tendon rupture resulted from repeated entrapment due to pisotriquetral instability. This instability, caused by ligament damage, led to an attritional tendon lesion without bone abnormalities.
Area of Science:
- Orthopedic Surgery
- Hand and Wrist Surgery
- Sports Medicine
Background:
- Closed rupture of the flexor digitorum profundus tendon is uncommon.
- Pisotriquetral instability can arise from pisotriquetral ligament lesions.
- Repetitive tendon impingement may lead to attritional tendon failure.
Observation:
- A case of closed flexor digitorum profundus tendon rupture in the small finger is presented.
- The patient exhibited pisotriquetral instability attributed to pisotriquetral ligament damage.
- No bone abnormalities were observed in the pisotriquetral joint.
Findings:
- The flexor digitorum profundus tendon was repeatedly entrapped between the pisiform and triquetrum.
- This chronic entrapment resulted in an attritional lesion of the tendon.
- Pisotriquetral instability was identified as the likely predisposing factor.
Implications:
- Understanding the biomechanics of pisotriquetral instability is crucial for diagnosing tendon injuries.
- This case highlights a potential mechanism for closed flexor digitorum profundus tendon rupture.
- Conservative or surgical management of pisotriquetral instability may prevent tendon attrition.