J Korean Foot Ankle Soc.  2016 Mar;20(1):46-49. 10.14193/jkfas.2016.20.1.46.

Spontaneous Rupture of the Second and Third Extensor Digitorum Longus Tendons Caused by Osteophyte of the Tarsometatarsal Joint: A Case Report

  • 1Department of Orthopedic Surgery, Gyeongsan Joongang Hospital, Gyeongsan, Korea.
  • 2Department of Orthopaedic Surgery, Yeungnam University College of Medicine, Daegu, Korea. chpark77@naver.com


Spontaneous rupture of the extensor tendon has been reported in association with predisposing inflammatory conditions including rheumatoid arthritis, diabetes, trauma, tophaceous gout, and steroid injection. The authors experienced a case of spontaneous rupture of the extensor digitorum longus tendons caused by an osteophyte of the tarsometatarsal joint in a patient with rheumatoid arthritis. The authors stress that aggressive treatment including surgery could be considered for prevention of spontaneous tendon rupture in a patient with predisposing conditions despite an asymptomatic spur.


Rheumatoid arthritis; Flatfoot; Osteophyte; Extensor tendon rupture

MeSH Terms

Arthritis, Rheumatoid
Rupture, Spontaneous*


  • Figure 1. Preoperative photograph shows the patient unable to actively extend the second and third toe.

  • Figure 2. Preoperative anteroposterior (A) and lateral (B, C) radiographs show flatfoot deformity in both feet, and space narrowing of tarsometatarsal and naviculocuneiform joints with an osteophyte of tarsometatarsal joint in left foot.

  • Figure 3. Preoperative ultrasonographs show an osteophyte of tarsometatarsal joint (A) and rupture of second and third extensor digitorum longus tendons (B).

  • Figure 4. Intraoperative photographs show an osteophyte of tarsometatarsal joint (A), removal of an osteophyte (B), ruptured second and third extensor digitorum longus tendons (C), and repaired tendons using Pulvertaft technique (D).

  • Figure 5. (A, B) Photographs taken at one year after surgery show active range of motion of operated toes.



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