Spontaneous Flexor Tendon Rupture of the Burned Hand

ABSTRACT

PURPOSE: Spontaneous tendon rupture of finger is defined the rupture of tendon without any intrinsic or extrinsic pathological processes in finger. Spontaneous flexor tendon ruptures are rare. Burn affects not only skin but also muscle and tendon according to the depth. Particularly, burn in hand badly affects movement of finger. Thus, We report the case of spontaneous flexor tendon rupture of finger that happened after burn. METHODS: We studied a 42 year old male presented with third degree electrical burn at the palm of the right hand. And then, Terudermis(R) was applied on 23rd day after burn and split thickness skin graft was applied on 37th day after burn. After operation, there were no special symptoms for some period. But, on 74th day after burn, while providing physical therapy to finger, he could not flex his thumb of the hand with popping sound and edema. So we performed US and MRI scan, finally diagnosed complete tear on FPL tendon of the right hand which was in flexor tendon injury zone IV. We harvested donor from Palmaris longus and tendon graft was applied. RESULTS: After operation, graft was well taken without other problem. And after applying splint, 4th day after tendon graft, active finger extension was done with passive flexion achieved using a rubber band attached to the finger tip. 4 weeks after the operation, splint was removed and the patient gently started active exercise. CONCLUSION: Spontaneous rupture of flexor tendon is rare and moreover, there was no case report of rupture after burns so far. We are now reporting that we early diagnosed the spontaneous flexor tendon rupture of the burned hand and functionally corrected by tendon graft.