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Case Report Plastic and Aesthetic Research

Rupture of the flexor carpi radialis tendon

secondary to trauma: case report and

literature review

Jonathan Kanevsky , Dino Zammit , Jean-Paul Brutus 3
1
2
1 Department of Plastic and Reconstructive Surgery, Montreal General Hospital, Montreal, QC H3G 1A4, Canada.
2 Faculty of Medicine, McGill Univeristy, Montreal, QC H3G 1Y6, Canada.
3 Centre Médical L’enjeu, Ville Mont-Royal, QC H3P 3E5, Canada.
Address for correspondence: Dr. Jonathan Kanevsky, Montreal General Hospital, 1650 Avenue Cedar, Montreal, QC H3G 1A4, Canada.
E-mail: jonkanevsky@gmail.com

ABSTRACT
The flexor carpi radialis (FCR) is one of the long flexors, which is important in flexing and abducting
the hand at the wrist. It originates at the medial epicondyle of the humerus and attaches at the base
of the second metacarpal. Closed rupture of the long flexors of the finger is well-described, especially
in association with rheumatoid hands. However, rupture of the FCR is rare; only 11 cases reported in
the literature, most of them associated with scaphotrapezial-trapezoidal osteoarthritis. We describe
1 case of complete FCR rupture secondary to trauma, showing that long-term disability following FCR
rupture is minimal.
Key words:
Flexor carpi radialis, rupture, trauma

INTRODUCTION and a notable swelling in the region of the left FCR. On
examination, there was tenderness along the course of
Closed rupture of the long flexors of the finger is well the FCR as well as a palpable mass at the FCR origin.
described, especially in association with rheumatoid There was minimal loss of function on range of motion.
hands. However, rupture of the flexor carpi radialis (FCR) Ultrasound/X-ray examination confirmed complete rupture
is rare with only 11 cases reported in the literature. of the FCR at its distal insertion. The FCR tendon and
Many of the described cases were associated with muscle belly retracted to approximately the proximal
scaphotrapezial-trapezoidal (STT) osteoarthritis. We describe third of the forearm. In addition to the tendinous injury,
1 case of complete FCR rupture secondary to trauma. radiograph revealed an osseous fragment attached to the
distal end of the torn tendon.
CASE REPORT Conservative treatment was decided to be the best
management of this patient given the 4-week delay from
A 24-year-old right-hand dominant, professional male onset of injury to presentation in the clinic. Furthermore,
boxer suffered a traumatic blow to the left forearm during given the patient’s profession as an athlete and minimal
a sparring match. Four weeks after injury he presented functional impairment, the decision was made to avoid
to the clinic with a complaint of pain in his left wrist
operative intervention and proceed to aggressive
physiotherapy. He was followed at 3 months, 6 months,
Access this article online and 1 year, and was able to return to boxing 2 months
after injury as deemed appropriate by the physical
Quick Response Code:
Website: therapist, occupational therapist, and surgeon.
www.parjournal.net
DISCUSSION
DOI:
10.4103/2347-9264.157108 The FCR tendon runs through a synovial fibro-osseous
tunnel in the forearm to its insertion at the base of the

138 Plast Aesthet Res || Vol 2 || Issue 3 || May 15, 2015