Flexor Pollicis Longus Rupture in a Scaphoid Nonunion: A Case Report

Author:

Crepaldi Bruno E.1,Andrijich Courtney1ORCID,Ecker Jeff123

Affiliation:

1. Jeff Ecker Clinic, Bethesda Hospital, Claremont, Western Australia, Australia

2. Health Sciences Department, Curtin University, Bentley, Western Australia, Australia

3. Hand and Upper Limb Centre, Claremont, Western Australia, Australia

Abstract

Abstract Background Flexor pollicis longus (FPL) tendon rupture is a rare complication of scaphoid nonunion. Case Description A fit active 70-year-old woman ruptured her FPL when it abraded on a painless 50-year-old scaphoid nonunion. She had asymptomatic scaphoid nonunion advanced collapse (SNAC) arthritis. At surgery, the sharp mobile volar scaphoid osteophytes were excised and the volar wrist capsule was repaired. A vascularized fat flap based on a perforator of the radial artery was used to augment the volar wrist capsule repair and to create a smooth gliding surface for the FPL. The ruptured FPL tendon was reconstructed with a palmaris longus graft. Literature Review Complete rupture of the FPL tendon secondary to scaphoid nonunion is a rare complication. It can be easily misdiagnosed because the original injury may be unrecognized or forgotten. A consensus regarding the optimal surgical management has not been reached. Clinical Relevance The objective of surgery in this case was to restore FPL function and prevent a recurrent rupture. The asymptomatic SNAC arthritis was not treated. No further wrist surgery was required. The patient was asymptomatic with a functioning FPL tendon 4 years after surgery.

Publisher

Georg Thieme Verlag KG

Subject

Orthopedics and Sports Medicine,Surgery

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