The outcome of untreated flexor pollicis longus rupture in patients with rheumatoid arthritis

Hand Surg Rehabil. 2020 Dec;39(6):508-510. doi: 10.1016/j.hansur.2020.08.002. Epub 2020 Aug 18.

Abstract

The aim of the study was to assess the natural history of untreated flexor pollicis longus (FPL) tendon rupture in patients with rheumatoid arthritis (RA). We reviewed a cohort of patients to assess the long-term effect of conservative management. We reviewed nine of 11 consecutive patients. We assessed objective outcomes including ranges of motion and strength and subjective outcomes including pain and function scores. We assessed seven women and two men. They had a mean age of 67 (range 48-82) years. Six of the nine patients had no more symptoms on the side of their FPL rupture than in the other thumb. Two were mildly more symptomatic and one much more symptomatic. Late thumb hyperextension did not appear to be a symptomatic problem. We recommend waiting at least 6 weeks before considering surgical reconstruction in patients who have an FPL rupture secondary to RA. The majority will recover so well that they may not choose reconstructive surgery. Level of evidence: IV.

Keywords: Flexor pollicis longus; Outcome; Polyarthrite rhumatoïde; Pouce; Rheumatoid arthritis; Rupture; Résultat; Thumb.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / complications*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Rupture / etiology
  • Rupture / therapy
  • Tendon Injuries / etiology
  • Tendon Injuries / therapy*
  • Visual Analog Scale
  • Watchful Waiting