[Spontaneous Tendon Ruptures in the Rheumatoid Hand]

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.
• 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.