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Delayed flexor pollicis longus tendon rupture following sharp trauma

Case contributed by Roberto Schubert
Diagnosis almost certain

Presentation

Loss of the end of the phalanx flexion of the thumb 4 weeks after a knife attack with injury to the palm of the hand.

Patient Data

Age: 25 years
Gender: Male

Diffuse T2-hyperintense granulation tissue / organized hematoma in the thenar region and the 1st intermetacarpal space. Absent depiction of the FPL tendon from the MCP joint down to the carpal tunnel.

Case Discussion

Late rupture is one of several possible complcations after traumatic partial laceration of the FPL tendon1.

Post-traumatic FPL tendon ruptures must be differentiated from Mannerfelt syndrome, referring to attrition rupture of the FPL tendon caused by bony spurs at the scaphoid or in the carpal tunnel, a typical complication in rheumatoid arthritis.

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