Open Access, Peer-reviewed
pISSN 1226-2102
eISSN 2005-8918
    J Korean Orthop Assoc. 2015 Aug;50(4):348-352. Korean.
    Published online Aug 24, 2015.
    https://doi.org/10.4055/jkoa.2015.50.4.348
    Copyright © 2015 by The Korean Orthopaedic Association
    Case Report

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

    Jung Hyun Park, M.D., Hong Je Kang, M.D., and 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, Email: kanghongje@hanmail.net
    Received October 22, 2014; Revised February 25, 2015; Accepted April 13, 2015.

    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

    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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    MeSH Terms
    Dislocations*
    Rupture*
    Tendons*
    Ulnar Nerve
    Metrics
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