Extensor Tendon Rupture in Non-Traumatic Osteoarthritis of Distal Radioulnar Joint: Vaughan-Jackson Syndrome – A Rare Case Report from Indian Subcontinent

Abstract Background Previous study demonstrated that distal radioulnar joint (DRUJ) plays a biomechanical role in extension and flexion of the wrist and suggested that fixation of the DRUJ could lead to loss of motion of the wrist. Little is known about the pre- and postoperative range of motion (ROM) after the Sauvé–Kapandji (S-K) and Darrach procedures without tendon rupture. To understand the accurate ROM of the wrist after the S-K and Darrach procedures, enrollment of patients without subcutaneous extensor tendon rupture is needed. Purpose This study aimed to investigate the pre- and postoperative ROM after the S-K and Darrach procedures without subcutaneous extensor tendon rupture in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Methods This retrospective study included 36 patients who underwent the S-K procedure and 10 patients who underwent the Darrach procedure for distal radioulnar joint disorders without extensor tendon rupture. Pre- and postoperative ROMs after the S-K and Darrach procedures were assessed 1 year after the surgery. Results In the S-K procedure, the mean postoperative ROM of the wrist flexion (40 degrees) was significantly lower than the mean preoperative ROM (49 degrees). In wrist extension, there were no significant differences between the mean preoperative ROM (51 degrees) and postoperative ROM (51 degrees). In the Darrach procedure, the mean postoperative ROM of the wrist flexion and extension increased compared with the mean preoperative ROM; however, there were no significant differences. Conclusion In the S-K procedure, preoperative ROM of the wrist flexion decreased postoperatively. This study provides information about the accurate ROM after the S-K and Darrach procedures. Level of Evidence This is a Level IV, therapeutic study.

Download Full-text

Simultaneous Acute Achilles Tendon and Bilateral Quadriceps Tendon Rupture: a Rare Case Report

Shafa Orthopedic Journal ◽

10.17795/soj-451 ◽

2015 ◽

Vol 2 (1) ◽

Author(s):

Ebrahim Zonozi ◽

Ali Jahansouz

Keyword(s):

Case Report ◽

Achilles Tendon ◽

Rare Case ◽

Tendon Rupture ◽

Quadriceps Tendon ◽

Quadriceps Tendon Rupture ◽

Rare Case Report ◽

Bilateral Quadriceps Tendon Rupture

Download Full-text

Ulnar Stump Stabilization Using the Flexor Carpi Ulnaris Tendon for the Rheumatoid Wrist

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835519500577 ◽

2019 ◽

Vol 24 (04) ◽

pp. 447-451 ◽

Cited By ~ 1

Author(s):

Asami Abe ◽

Hajime IshikawaKim

Keyword(s):

Computed Tomography ◽

Tendon Rupture ◽

Extensor Tendon ◽

Distal Radioulnar Joint ◽

Forearm Rotation ◽

Radioulnar Joint ◽

Ulnar Head ◽

Ulnar Head Resection ◽

Flexor Carpi Ulnaris ◽

Grip Power

Background: The objective of this retrospective study was to evaluate the outcomes of ulnar stump stabilization after ulna head resection using the FCU tendon by investigating the rate of postoperative extensor tendon rupture and click on forearm rotation. Methods: Wrist synovectomy (distal radioulnar joint (DRUJ), radiocarpal and midcarpal joints) and ulnar head resection combined with ulnar stump stabilizing procedure were performed in 58 wrists of 53 patients with RA in our hospital. Before operation, the dorsal subluxation ratio (DSR) of the ulnar head was measured with a multi-slice computed tomography (CT) images. The stabilization of ulnar stump after head resection was performed by the value of the DSR or the instability before the operation. Results: There was neither extensor tendon rupture nor click on forearm rotation in all the patients. Smooth forearm rotation was achieved by ulnar head resection and stabilizing procedure for the ulnar stump. The active range of forearm supination and pronation increased significantly from 68° ± 23° (mean ± SD) to 80° ± 10°, and from 69° ± 17° to 74° ± 13°. The grip power increased from 117 ± 62 mmHg to 185 ± 55 mmHg. In the assessment using 3DCT, the preoperative DSR of 54% improved to 8% on the whole (n = 58). In the wrists with extensor tendon rupture (n = 36), the preoperative DSR of 58% improved to 12%. In the wrists without tendon rupture (n = 22), the preoperative DSR of 46% improved to 2%. Conclusions: The operative technique of ulnar stump stabilization using the FCU tendon was one of the suitable procedure to prevent complications after ulnar head resection.

Download Full-text

HECK'S DISEASE – A RARE CASE REPORT

10.36106/gjra/1503473 ◽

2021 ◽

pp. 40-43

Author(s):

Seema Patil ◽

M. Ekta ◽

Asha. R. Iyengar ◽

Revan Kumar Joshi ◽

Ritika Agarwal ◽

...

Keyword(s):

Case Report ◽

Oral Mucosa ◽

Rare Case ◽

Unusual Case ◽

Indian Subcontinent ◽

Case Reports ◽

Benign Lesion ◽

Human Papilloma Viruses ◽

Rare Case Report ◽

Indian Male

Heck's disease is a familial benign lesion affecting the oral mucosa and skin caused by Human papilloma viruses 13 and 32. This condition is quite rare in the Indian subcontinent and till date less than 10 case reports have been published. Females are predominantly affected. It is important for an oral physician to be aware and possess sufcient knowledge about these lesions as these lesions are highly contagious. Further, the presence of these lesions may indicate an underlying immunodecient state of the patient. This paper reports an unusual case of Heck's disease in a 30 year old Indian male.

Download Full-text

Extensor Tendon Rupture Associated with Osteoarthritis of the Distal Radioulnar Joint

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408090098 ◽

2008 ◽

Vol 33 (4) ◽

pp. 469-474 ◽

Cited By ~ 11

Author(s):

H. YAMAZAKI ◽

S. UCHIYAMA ◽

Y. HATA ◽

N. MURAKAMI ◽

H. KATO

Keyword(s):

Risk Factors ◽

Tendon Rupture ◽

Extensor Tendon ◽

Distal Radioulnar Joint ◽

X Rays ◽

Radioulnar Joint ◽

Ulnar Head ◽

Sigmoid Notch ◽

Tendon Ruptures ◽

Grade 3

Non-rheumatoid osteoarthritis of the distal radioulnar joint can cause extensor tendon rupture. We analysed the radiographic morphology of the distal radioulnar joint to identify the risk factors for this complication. Forty-one wrist X-rays of 37 patients with extensor tendon rupture caused by distal radioulnar joint osteoarthritis were evaluated retrospectively for the severity of osteoarthritis by the Kellgren/Lawrence scoring system. Measurements were obtained from posteroanterior views. All but one wrist had severe osteoarthritic changes exceeding grade 3. The radiographic features that were different from those of the contralateral wrists included deepening and widening of the sigmoid notch, radial shift of the ulnar head and dorsal inclination of the sigmoid notch. There was no significant association between tendon rupture and the morphology of the ulnar head or ulnar variance. The scallop sign, dorsal inclination of the sigmoid notch and radial shift of the ulnar head are radiological risk factors for extensor tendon ruptures.

Download Full-text

ACUTE PLASTIC BOWING OF THE RADIUS WITH A DISTAL RADIOULNAR JOINT INJURY: A CASE REPORT

Hand Surgery ◽

10.1142/s0218810410004916 ◽

2010 ◽

Vol 15 (03) ◽

pp. 217-220 ◽

Cited By ~ 1

Author(s):

Masashi Uehara ◽

Hiroshi Yamazaki ◽

Hiroyuki Kato

Keyword(s):

Case Report ◽

Internal Fixation ◽

Radial Head ◽

Rare Case ◽

Distal Radioulnar Joint ◽

Ulnar Styloid ◽

Joint Injury ◽

Radioulnar Joint ◽

Joint Injuries ◽

Macroscopic Fracture

Acute plastic bowing is an incomplete fracture with a deformation that shows no obvious macroscopic fracture line or cortical discontinuity. Although cases of acute plastic bowing of the ulna with a dislocation of the radial head have been previously reported, we present here a rare case of acute plastic bowing of the radius with a distal radioulnar joint injury in a 16-year-old boy. Internal fixation of the detached fragment to the ulnar styloid and repair of the triangular fibrocartilagenous complex resulted in the disappearance of wrist pain. In cases of distal radioulnar joint injuries in children or adolescents, radiographs of the entire forearm should be taken to evaluate the existence of radial bowing.

Download Full-text

IRREDUCIBLE CHRONIC PALMAR DISLOCATION OF THE DISTAL RADIOULNAR JOINT – A CASE REPORT

Hand Surgery ◽

10.1142/s0218810405002930 ◽

2005 ◽

Vol 10 (02n03) ◽

pp. 319-322 ◽

Cited By ~ 7

Author(s):

Y. Kikuchi ◽

T. Nakamura ◽

Y. Horiuchi

Keyword(s):

Case Report ◽

Rare Case ◽

Distal Radioulnar Joint ◽

Dynamic Force ◽

Ulnar Styloid ◽

Pronator Quadratus ◽

Radioulnar Joint ◽

Ulnar Head ◽

The Stability ◽

Pronator Quadratus Muscle

We report a rare case of irreducible chronic palmar dislocation of the distal radioulnar joint (DRUJ). This case showed that the dislocated ulnar head was impacted to the palmar cortex of the radius probably due to the dynamic force of the pronator quadratus muscle. Re-attachment of the ulnar styloid and partial resection of the ulnar head were necessary to make the reduction of the DRUJ possible. The continuity of the radioulnar ligament to the ulnar head was restored and the stability of DRUJ was maintained after reduction.

Download Full-text

Extensor Tendon Rupture After Distal Radioulnar Joint Surgery: A Case Series

Cureus ◽

10.7759/cureus.14118 ◽

2021 ◽

Author(s):

Connor Fletcher ◽

Francis J Sirch ◽

Daniel Fletcher ◽

Jonas Matzon ◽

Pedro Beredjiklian

Keyword(s):

Tendon Rupture ◽

Case Series ◽

Extensor Tendon ◽

Distal Radioulnar Joint ◽

Radioulnar Joint ◽

Joint Surgery

Download Full-text

Extensor Tendon Rupture Due to Osteoarthritis of the Distal Radio-Ulnar Joint

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(91)90026-k ◽

1991 ◽

Vol 16 (4) ◽

pp. 450-453 ◽

Cited By ~ 15

Author(s):

I. OHSHIO ◽

T. OGINO ◽

A. MINAMI ◽

H. KATO ◽

A. MIYAKE

Keyword(s):

Tendon Transfer ◽

Tendon Rupture ◽

Extensor Tendon ◽

Distal Radioulnar Joint ◽

Tendon Graft ◽

Distal Ulna ◽

Radioulnar Joint ◽

Dorsal Aspect ◽

Closed Rupture ◽

Little Finger

Five cases of closed rupture of the finger extensor tendon due to osteoarthritis of the distal radioulnar joint were studied. Difficulty in extension began at the little finger and extended to the ring and long fingers. Pain and swelling in the dorsal aspect of the wrist preceded the tendon rupture. Osteoarthritic changes at the distal radio-ulnar joint were more severe than those at the radio-carpal and intercarpal joints. The distal end of the ulna showed the plus variant, as well as dorsal dislocation or subluxation. All patients underwent a tendon graft or tendon transfer, with excision of the distal ulna. The tendon rupture was thought to be caused mainly by friction between the displaced distal end of the ulna and osteophytes of the distal radio-ulnar joint.

Download Full-text