Delayed rupture of all finger flexor tendons (excluding thumb) following nonoperative treatment of Colles' fracture: A case report and literature review

Abstract

Rupture Wrist a b s t r a c tAims: We report a case of delayed all digital flexor tendon ruptures after nonoperative management of distal radius fracture.Methods: An 84-year-old woman, noted loss of flexion of your fingers. She had a history of Colles' fracture 40 years before, which had been left untreated. Darrach procedure were carried and a tendon transfers for the flexor tendon ruptures.Results: Despite attempts of early active mobilisation, a poor operative outcome was observed. Conclusion:Tendon rupture can occur several months or years after the injury, and prompt recognition and treatment can minimize disability.

Delayed rupture of the flexor tendons as a complication of malunited distal radius fracture after nonoperative management: A report of two cases

“…Indeed, poor results were related to the number of ruptured tendons rather than the surgical procedure. In particular, patients who sustained ruptures of all FDPs and FDSs had a poor prognosis, while patients with one or two ruptured tendons obtained good outcomes [8,14,22,23]. Consistent with this evidence, our Case 1 acquired excellent outcome, whereas Case 2 did not.…”

“…Although not significant, ruptures of radial flexor tendons tended to occur earlier than ulnar flexor tendon ruptures. According to the previous literature, the main causes of delayed flexor tendon ruptures are “the bony spike at the palmar aspect of the distal radius”, “palmarly displaced ulnar head”, or both simultaneously [23]. As a result of statistical analysis, radial bony spike caused tendon ruptures significantly earlier than palmarly displaced ulnar head (Fig.…”

“…Rupture of the flexor tendons is a rare complication following distal radius malunion after nonoperative management. To date, 27 cases of delayed tendon ruptures (>4 weeks after injury) have been reported in 23 English articles [[4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23],[28], [29], [30]]. We evaluated a total of 29 cases including our reported 2 cases (Table 1) and investigated the mechanism, characteristics, operative management, and outcomes of this complication.…”

“…Regarding osseous surgery, 22 cases were available for analysis (Table 1). Of 8 operations for the ulnar head, 6 used the Darrach procedure, including our Case 2 [5,10,14,16,19,21,23], 1 used the Sauve-Kapandji procedure [21], and 1 used debridement of the osteophyte [10]. By contrast, of 14 operations for the radius, 10 used only excision of the bony spike [9,[11], [12], [13],15,17,20,22,28], and 4 used corrective osteotomy of the distal radius, including our Case 1 [7,20,21].…”

“…Rupture of the flexor tendon is a well-known complication after palmar locking plate fixation for distal radius fractures, and its incidence has been reported as 0.3% to 0.9% [[1], [2], [3]]. However, flexor tendon rupture associated with distal radius fracture after nonoperative treatment is uncommon complication [[4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31]]. This complication can be managed by reconstruction of the ruptured tendons and surgery for the osseous lesion that caused the tendon ruptures.…”