Risk factors for rupture of extensor tendons in the rheumatoid wrist

This study assessed the risk factors for spontaneous extensor tendon rupture in the rheumatoid wrist. The rupture group consisted of 25 wrists that had rupture of the extensor tendons and later received tendon reconstruction. The non-rupture group included 77 rheumatoid wrists without extensor tendon rupture. We assessed patients' pain at the distal radioulnar joint and swelling in the extensor tendon compartments clinically, matrix metalloproteinase-3 level in blood samples, and radiographic findings. We found that swelling in the extensor tendon compartments, the scallop sign, and severe dorsal subluxation are significantly associated with spontaneous extensor tendon rupture, but serum matrix metalloproteinase-3 level is not. Level of evidence: IV

Radiotriquetral arthrodesis for rheumatoid wrist with flexor tendon rupture: A case report

Flexor tendon rupture in the wrist of patients with rheumatoid arthritis is a rare complication, and there is no standard treatment for the wrist joint. Here, we present the case of a rupture of the flexor digitorum profundus of the left index finger owing to a rheumatoid wrist. Plain radiography and computed tomography showed carpal collapse, especially lunate, and arthrosis between the capitate and lunate. For stability and mobility of the wrist and index finger, resection of the lunate and radiotriquetral (RT) arthrodesis using the distal ulna as a bone graft and arthrodesis of the distal interphalangeal joint of the index finger were performed. At 2 years postoperatively, her wrist was painless and stable on radiography without recurrence of tendon rupture, and the arc of motion of the dorsal-palmar flexion of the wrist joint was 125°. RT arthrodesis could be a surgical choice of “mobile” partial wrist arthrodesis.