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Rheumatoid Arthritis: Flexor Tendon Rupture


- See:
       - FDP rupture
       - FPL rupture
       - Teno-synovectomy

- Discussion:
    - when flexor tendon ruptures occur, there are two usual causes:
    - attrition or direct invasion by tenosynovitis;
    - these occur in carpal canal due to invasion or attrition;
    - scaphoid bone is most common site for the attrition process
    - FPL, FDS, & FDP to index fingers are tendons most often involved w/ attrition ruptures;

- Exam:
    - affected finger tends to have an extended appearance;

- Treatment Considerations:
    - rheumatoid FDP rupture needs to be distinguished from FDP rupture;
    - if both the FDS and the FDP tendons are ruptured, then consider PIP fusion;
    - see FPL Rupture:
    - most important factor for determining type of treatment is level of tendon rupture;
    - w/ tendon ruptures in the palm the distal tendon end may be sutured to the adjacent intact tendon



Flexor tendon ruptures in rheumatoid arthritis.

Flexor tenosynovitis in the rheumatoid hand.