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[Spontaneous Tendon Ruptures in the Rheumatoid Hand].

J Pech, D Veigl, M Vlček

Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca

|December 28, 2016

Summary

Rheumatoid arthritis can cause spontaneous tendon ruptures in the hand, leading to joint dysfunction. Early surgical intervention and prophylactic procedures are crucial for preventing and managing these debilitating ruptures.

Area of Science:

Rheumatology
Orthopedic Surgery
Hand Surgery

Background:

Rheumatoid arthritis (RA) frequently causes spontaneous tendon ruptures.
These ruptures can occur without trauma, often during sleep, leading to functional deficits in the hand.
RA-induced tendon damage results from inflammatory processes, mechanical stress, or ischemic damage.

Purpose of the Study:

To review the causes and mechanisms of spontaneous tendon ruptures in rheumatoid arthritis.
To discuss the surgical management and reconstructive techniques for tendon injuries in RA patients.
To highlight the importance of prophylactic measures in preventing tendon ruptures and deformities.

Main Methods:

Literature review of spontaneous tendon ruptures in rheumatoid arthritis.

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Analysis of etiological factors including inflammation, mechanical injury, and ischemia.

Evaluation of surgical repair strategies, including tendon transfer and grafting.

Main Results:

Spontaneous tendon ruptures in RA are linked to inflammation, mechanical factors, and vascular compromise.
Tendon repair often requires complex procedures like tendon transfer or grafting, as simple suture is usually insufficient.
Flexor tendon repairs are technically more challenging and yield less favorable outcomes than extensor tendon repairs.

Conclusions:

Early synovectomy and prophylactic interventions can prevent or mitigate spontaneous tendon ruptures in RA.
Tendon reconstruction in RA necessitates specialized surgical techniques, with varying success rates.
Effective management requires a comprehensive approach addressing both inflammatory disease control and surgical repair.