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A Rare Case of Extensor Digitorum Communis Rupture Due to Pancarpal Arthritis.

Salman Shiraz1, Laxminarayan Bhandari1

  • 1Christine M. Kleinert Institute for Hand and Microsurgery, University of Louisville, 225 Abraham Flexner Way, Suite 850, Louisville, Kentucky, United States.

Indian Journal of Plastic Surgery : Official Publication of the Association of Plastic Surgeons of India
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PubMed
Summary

A rare case of extensor digitorum communis (EDC) tendon rupture caused by a prominent lunate bone in a patient with wrist arthritis is detailed. Surgical repair and tendon transfer restored finger extension.

Keywords:
lunatetendonwrist arthritis

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Area of Science:

  • Orthopedic Surgery
  • Hand Surgery
  • Rheumatology

Background:

  • Pancarpal arthritis and distal radio-ulnar joint (DRUJ) osteoarthritis can lead to complex upper extremity issues.
  • Extensor digitorum communis (EDC) tendon rupture is uncommon, especially when associated with specific bony abnormalities.

Observation:

  • A 71-year-old man with a history of prolonged chainsaw use presented with inability to extend his small and ring fingers.
  • Physical examination revealed zero power in the EDC of the affected fingers.
  • Radiographs showed pancarpal arthritis with a dorsally displaced lunate and DRUJ osteoarthritis.

Findings:

  • Intraoperative findings identified a sharp posterior lunate prominence as the cause of EDC tendon attrition and rupture.
  • The DRUJ surface was noted to be relatively smooth.
  • Surgical intervention included proximal row carpectomy and extensor indicis proprius (EIP) to EDC tendon transfer.

Implications:

  • This case highlights a unique etiology for EDC tendon rupture secondary to carpal bone morphology.
  • Successful surgical management involving tendon transfer restored full finger extension.
  • This report may inform surgical approaches for similar rare presentations of wrist pathology and tendon injury.