Flexor Carpi Radialis Tendinitis to Rupture: A Case Series and Algorithm.

Area of Science:

• Orthopedics
• Hand Surgery
• Musculoskeletal Disorders

Background:

• Flexor carpi radialis (FCR) tendinitis presents as uncommon volar radial wrist pain.
• It poses diagnostic and therapeutic challenges for clinicians.
• Successful management algorithms are crucial for this condition.

Purpose of the Study:

• To present a series of patients with FCR tendinitis.
• To demonstrate successful management using a senior author-developed algorithm.
• To evaluate patient outcomes based on the FCR algorithm.

Main Methods:

• Retrospective review of patients treated for FCR tendinitis.
• Treatment guided by magnetic resonance imaging (MRI) and intraoperative findings of FCR tendon rupture percentage.
• Algorithm categorized treatment into conservative, FCR-sparing surgery, or FCR-sacrificing surgery based on rupture severity.

Main Results:

• Sixteen patients were treated; 5 conservatively, 11 surgically.
• Conservative treatment yielded complete symptom relief in 3 of 5 patients.
• All 11 surgical patients achieved satisfactory functional and clinical outcomes, with procedures tailored to rupture severity (<50% vs. >50%).

Conclusions:

• The presented FCR algorithm demonstrates acceptable patient outcomes.
• Utilizing 50% tendon involvement as a benchmark effectively guides treatment decisions.
• This algorithm offers a structured approach to managing FCR tendinitis.