Extensor Tendon Rupture Following Osteoarthritis of the Distal Radioulnar Joint

Abstract

Extensor tendon rupture in association with osteoarthritis of the distal radioulnar joint rarely occurs.
The purpose of this study was to examine seven cases (eight hands), and investigate the factors and mechanism of extensor tendon rupture, as well as the differences between genders and the causes of pain from individual radiographs and previous findings.
The causes of high incidence of a tendon rupture were the dorsal inclination of the sigmoid notch and ulnar plus variance which occurs frequently among males.
The mechanism of tendon rupture was synovitis around the tendon, and disruption of the blood supply to the tendon, as well as mechanical friction to the tendon resulting from the dorsal inclination of the sigmoid notch, ulnar plus variance, and the change of the ulnar head to osteoarthritis.
Lower contact pressure between the carpals and dorsally shifted ulnar head may reduce symptomatic pain.
Because of painlessness or minimum pain, many patients seek medical assistance long after the tendon ruptures. Therefore as a treatment option, reconstructive surgery is needed which includes treatment of the ulnar head and tendon transfer.