High incidence and treatment of flexor carpi radialis tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty for basal joint arthritis

Abstract

We reviewed the incidence and treatment of flexor carpi radialis tendinitis in 77 patients (81 thumbs) who had trapeziectomy and abductor pollicis longus suspensionplasty for thumb carpometacarpal joint arthritis. Eighteen patients, 20 wrists (25%) had flexor carpi radialis tendinitis. The onset was 2-10 months (mean 4.7) after surgery. Two cases had preceding trauma. Eight cases (40%) responded to splinting and steroid injection. Ten patients, 12 wrists (60%) underwent surgery after failing non-operative treatment. Eleven wrists had frayed or partially torn flexor carpi radialis tendon and one had a complete tendon rupture with pseudotendon formation. Flexor carpi radialis tenotomy and pseudotendon excision were performed. All operated patients obtained good pain relief initially post-operatively. However, the pain recurred in two patients after 8 months. One required a local steroid injection for localized tenderness at the site of the proximal tendon stump. The other patient required a revision operation for scaphotrapezoid impingement. Both obtained complete pain relief. Our study has shown a high incidence of flexor carpi radialis tendinitis following trapeziectomy and abductor pollicis longus suspensionplasty. Patients should be warned about this potential complication.

Revision Ligament Reconstruction Tendon Interposition for Trapeziometacarpal Arthritis: A Case-Control Investigation

“…The causes of failure of LRTI include sensory disturbances, tendinitis, graft displacement, persistent pain, instability, infection, and implant migration 6,17,18 . Revision LRTI is performed either in the setting of mechanical failure of the index operation or to improve subjective pain.…”

Rupture of the flexor carpi radialis tendon secondary to trauma: case report and literature review

“…Functional problems after tendon rupture are minimal, and retraction of the tendon stump often makes reattachment difficult. [5] In fact, the FCR is a useful donor for arthroplasty tendon can be safely used in the reconstruction. [6] In the case of partial ruptures, management with immobilization has been reported to successfully treat pain.…”

“…[2] Good functional results have been reposted from simple splinting. [5] Occupational therapy is considered the standard of treatment and consists of active and passive range of motion exercises after 3 weeks of splinting. Functional problems after tendon rupture are minimal, and retraction of the tendon stump often makes reattachment difficult.…”

Komplikationsmanagement nach Resektionsarthroplastik bei Daumensattelgelenkarthrose

“…Tendinopathie der M.-flexor-carpi-radialis-Sehne infolge einer Suspension Verursacht wird die Tendinopathie in der Regel durch eine Umflechtung eines Streifens der M.-abductor-pollicis-longus-Sehne um die M.-flexor-carpi-radialis-Sehne[14]. Durch exzessive Handgelenkbewegung wird die Problematik verstärkt und es kann sich eine Synovialitis der M.-flexor-carpi-radialis-Sehne entwickeln.…”