Flexor tendon ruptures in rheumatoid arthritis.

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Hand Surgery

Background:

• Rheumatoid arthritis (RA) frequently causes flexor tendon ruptures.
• These ruptures are primarily due to attrition from bone spurs or invasive tenosynovitis.
• Attrition ruptures within the carpal canal are the most common cause.

Observation:

• Attrition ruptures, the most common, occur in the carpal canal.
• Invasive tenosynovitis can cause ruptures within the carpal canal or digits.
• Digital sheath ruptures, especially in zone 2, have a poor prognosis.

Findings:

• Rupture location, cause (attrition vs. invasive), and RA severity impact prognosis.
• Carpal canal attrition ruptures generally have a better prognosis than invasive tenosynovitis.
• Increased rupture number and digital involvement worsen outcomes.

Implications:

• Early tenosynovectomy and bone spur removal are crucial for prevention.
• Surgical outcomes depend heavily on RA severity and articular involvement.
• Reconstruction success is linked to tendon condition and rupture characteristics.