Multiple Flexor Tendon Ruptures with Compression Neuropathy at Neglected Volar Lunate Dislocation

Jung Hyun Park; Hong Je Kang; Jong Seok Baik

doi:10.4055/jkoa.2015.50.4.348

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Park, Kang, and Baik: Multiple Flexor Tendon Ruptures with Compression Neuropathy at Neglected Volar Lunate Dislocation

Case Report

Journal of the Korean Orthopaedic Association 2015; 50(4): 348-352.

Published online: 24 August 2015

DOI: https://doi.org/10.4055/jkoa.2015.50.4.348

Multiple Flexor Tendon Ruptures with Compression Neuropathy at Neglected Volar Lunate Dislocation

Jung Hyun Park, M.D., Hong Je Kang, M.D., Jong Seok Baik, M.D.

Department of Orthopaedic Surgery, Wonkwang University School of Medicine, Iksan, Korea.

Correspondence to: Hong Je Kang, M.D. Department of Orthopaedic Surgery, Wonkwang University Hospital, 895 Muwang-ro, Iksan 54538, Korea. TEL: +82-63-859-1360, FAX: +82-63-852-9329, kanghongje@hanmail.net

Received 22 October 2014 Revised 25 February 2015 Accepted 13 April 2015

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Perilunate dislocation represents approximately 3% of all carpal injuries and is diagnosed late in 25% of cases. Neglected perilunate dislocation accompanies many complications. Multiple flexor tendon rupture is a very rare complication of neglected perilunate dislocation. Three cases have been reported in the English literatures. No case has been reported in Korean literature. We report on a case of multiple flexor tendon ruptures with compressive neuropathy of median and ulnar nerve caused by neglected volar perilunate dislocation.

Keywords: perilunate dislocation, flexor tendon injury, compression neuropathy

Figures and Tables

Figure 1

Preoperative radiography. Anteroposterior and lateral view shows palmar lunate dislocation.

Figure 2

Computer tomography. (A) Lunate dose not appear in coronal view. (B, C) Lunate is volar dislocation into the carpal tunnel in sagittal and axial view.

Figure 3

Intraoperative view. (A) The 2, 3 flexor digitorum superficialis (FDS) were longitudinal splinted tear. (B) The 4, 5 FDS and 3, 4 flexor digitorum profundus (FDP) were completed rupture. Protruded lunate was shown under ruptured flexor tendons. (C) The 2, 3 FDS were repair. The 5 FDS and 3, 4 FDP underwent tendon graft using palmaris longus after lunate excision and volar radiocarpal ligament repair.

Figure 4

Radiography of postoperative one year, capitate has migrated proximally.

Notes

^{CONFLICTS OF INTEREST} The authors have nothing to disclose

References

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