J Korean Orthop Assoc.  2015 Aug;50(4):348-352. 10.4055/jkoa.2015.50.4.348.

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

• Park JH
• Kang HJ
• Baik JS

• KMID: 2035874
• DOI: http://doi.org/10.4055/jkoa.2015.50.4.348

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.

Keyword

perilunate dislocation; flexor tendon injury; compression neuropathy

MeSH Terms

Dislocations*
Rupture*
Tendons*
Ulnar Nerve

Figure

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  Figure 1 Preoperative radiography. Anteroposterior and lateral view shows palmar lunate dislocation.

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  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.

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  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.

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  Figure 4 Radiography of postoperative one year, capitate has migrated proximally.

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