Jui-Yuan Hung1, Shyu-Jye Wang, Shing-Sheng Wu. 1. Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Abstract
INTRODUCTION: Spontaneous rupture of the extensor pollicis longus (EPL) tendon has been reported in the literature. Various mechanisms have been proposed to account for this problem, but gouty infiltration is a rare mechanism. Here we report a patient with a long-standing history of gout who presented with sudden loss of interphalangeal extension of the left thumb. Spontaneous rupture of the EPL tendon caused by gout was discovered. MATERIALS AND METHODS: The successful treatment done involved surgical exploration and extensor indicis proprius tendon transfer. Postoperative thumb spica immobilization for 6 weeks was applied. RESULTS: Pathology disclosed urate crystals deposited within the ruptured EPL tendon. The functional recovery is satisfactory at the 1-year follow-up. CONCLUSION: Spontaneous rupture of the EPL tendon caused by gout is rare. Successful treatment was done with surgical management. Life-long medical follow-up to prevent a repeated acute attack can lower the risk of a large amount of tophaceous gout infiltration in tendons and may possibly prevent acute spontaneous tendon rupture.
INTRODUCTION: Spontaneous rupture of the extensor pollicis longus (EPL) tendon has been reported in the literature. Various mechanisms have been proposed to account for this problem, but gouty infiltration is a rare mechanism. Here we report a patient with a long-standing history of gout who presented with sudden loss of interphalangeal extension of the left thumb. Spontaneous rupture of the EPL tendon caused by gout was discovered. MATERIALS AND METHODS: The successful treatment done involved surgical exploration and extensor indicis proprius tendon transfer. Postoperative thumb spica immobilization for 6 weeks was applied. RESULTS: Pathology disclosed urate crystals deposited within the ruptured EPL tendon. The functional recovery is satisfactory at the 1-year follow-up. CONCLUSION: Spontaneous rupture of the EPL tendon caused by gout is rare. Successful treatment was done with surgical management. Life-long medical follow-up to prevent a repeated acute attack can lower the risk of a large amount of tophaceous gout infiltration in tendons and may possibly prevent acute spontaneous tendon rupture.
Authors: Eloy de Ávila Fernandes; Gabriel B Sandim; Sônia A V Mitraud; Edson S Kubota; Antonio J L Ferrari; Artur R C Fernandes Journal: Insights Imaging Date: 2010-07-04