Flexor Tendon Rupture Secondary to Gout.

Area of Science:

• Rheumatology
• Orthopedic Surgery
• Hand Surgery

Background:

• Extra-articular deposition of monosodium urate crystals is a known manifestation of gout.
• Gouty infiltration of flexor tendons in the hand leading to rupture is exceptionally rare.

Purpose of the Study:

• To report a rare case of flexor tendon rupture in the hand caused by gouty infiltration.
• To discuss the management and treatment of this unusual presentation of gout.

Main Methods:

• A case report detailing a patient with gouty infiltration of flexor tendons in the right middle finger.
• Surgical intervention involving a two-stage flexor tendon reconstruction and pulley reconstruction.
• Pharmacological management including febuxostat and prednisone.

Main Results:

• The patient experienced rupture of both the flexor digitorum profundus and flexor digitorum superficialis tendons.
• Successful two-stage reconstruction was performed, addressing the extensive gouty infiltration and pulley damage.
• Medications were used to manage crystal deposition and prevent flares during treatment.

Conclusions:

• Tendon rupture secondary to gouty infiltration should be considered in patients with a history of gout presenting with tendon insufficiency.
• A multidisciplinary approach involving surgery and medication is crucial for managing this rare condition.