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Subcutaneous Rupture of the Extensor Pollicis Longus Tendon after Corticosteroid Injections for DeQuervain's Stenosing Tenovaginitis.

Boussakri H, Bouali A - Case Rep Orthop (2014)

Bottom Line: Nonsurgical treatment by corticosteroid injection has significantly improved the management of this disease.The etiological history has not found any trauma history of the wrist.Our functional results were excellent.

View Article: PubMed Central - PubMed

Affiliation: Montpellier Institute of Surgery for the Hand, Clinical Clementville, 34000 Montpellier, France ; Department of Orthopaedic Surgery (B4), CHU Hassan II Hospital, University of Sidi Mohammed Ben Abdellah, 3000 Fez, Morocco.

ABSTRACT
DeQuervain's stenosing tenovaginitis is a common condition. Nonsurgical treatment by corticosteroid injection has significantly improved the management of this disease. The authors describe a case of subcutaneous rupture of the extensor pollicis longus tendon at the wrist, three months after two corticosteroid injections for DeQuervain's stenosing tenovaginitis. The etiological history has not found any trauma history of the wrist. The aim of our work is to draw attention to this rare complication and discuss its therapeutic management. Our functional results were excellent.

No MeSH data available.


Related in: MedlinePlus

Taking of the extensor indicis proprius tendon by a second incision on the dorsal surface of the metacarpophalangeal joint of the index finger.
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fig4: Taking of the extensor indicis proprius tendon by a second incision on the dorsal surface of the metacarpophalangeal joint of the index finger.

Mentions: Surgical Technique. Surgery is decided and performed under local anesthesia, by axillary brachial plexus block, a pneumatic tourniquet being inflated and placed at the limb radix. Surgical approach was focused on the anatomical snuff box. Intraoperatory view, we found a total rupture of the extensor pollicis longus tendon, the edges of this tendon were visualized but frayed, and there was a retraction of the proximal end. We also found about 10% diameter reduction of the extensor carpi radialis longus tendon without tendon rupture (Figure 3). We note the absence of the macroscopic sign of synovitis or tenosynovitis (Figure 3). The edges of the extensor pollicis longus tendon were debrided. The reconstruction of the tendon was performed using the extensor indicis proprius tendon, by a second incision on the dorsal surface of the metacarpophalangeal joint of the index finger (Figure 4). The distal end of the extensor indicis proprius tendon was sutured to the extensor digitorum communis, but the proximal stump was sutured to the distal end of the extensor pollicis longus, using a 3-0 nylon thread and then by continuous suture with 5-0 nylon monofilament thread, according to Pulvertaft repair technique (Figure 5).


Subcutaneous Rupture of the Extensor Pollicis Longus Tendon after Corticosteroid Injections for DeQuervain's Stenosing Tenovaginitis.

Boussakri H, Bouali A - Case Rep Orthop (2014)

Taking of the extensor indicis proprius tendon by a second incision on the dorsal surface of the metacarpophalangeal joint of the index finger.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4209778&req=5

fig4: Taking of the extensor indicis proprius tendon by a second incision on the dorsal surface of the metacarpophalangeal joint of the index finger.
Mentions: Surgical Technique. Surgery is decided and performed under local anesthesia, by axillary brachial plexus block, a pneumatic tourniquet being inflated and placed at the limb radix. Surgical approach was focused on the anatomical snuff box. Intraoperatory view, we found a total rupture of the extensor pollicis longus tendon, the edges of this tendon were visualized but frayed, and there was a retraction of the proximal end. We also found about 10% diameter reduction of the extensor carpi radialis longus tendon without tendon rupture (Figure 3). We note the absence of the macroscopic sign of synovitis or tenosynovitis (Figure 3). The edges of the extensor pollicis longus tendon were debrided. The reconstruction of the tendon was performed using the extensor indicis proprius tendon, by a second incision on the dorsal surface of the metacarpophalangeal joint of the index finger (Figure 4). The distal end of the extensor indicis proprius tendon was sutured to the extensor digitorum communis, but the proximal stump was sutured to the distal end of the extensor pollicis longus, using a 3-0 nylon thread and then by continuous suture with 5-0 nylon monofilament thread, according to Pulvertaft repair technique (Figure 5).

Bottom Line: Nonsurgical treatment by corticosteroid injection has significantly improved the management of this disease.The etiological history has not found any trauma history of the wrist.Our functional results were excellent.

View Article: PubMed Central - PubMed

Affiliation: Montpellier Institute of Surgery for the Hand, Clinical Clementville, 34000 Montpellier, France ; Department of Orthopaedic Surgery (B4), CHU Hassan II Hospital, University of Sidi Mohammed Ben Abdellah, 3000 Fez, Morocco.

ABSTRACT
DeQuervain's stenosing tenovaginitis is a common condition. Nonsurgical treatment by corticosteroid injection has significantly improved the management of this disease. The authors describe a case of subcutaneous rupture of the extensor pollicis longus tendon at the wrist, three months after two corticosteroid injections for DeQuervain's stenosing tenovaginitis. The etiological history has not found any trauma history of the wrist. The aim of our work is to draw attention to this rare complication and discuss its therapeutic management. Our functional results were excellent.

No MeSH data available.


Related in: MedlinePlus