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second metacarpal. As the tendon traverses the carpal donor for arthroplasty tendon can be safely used in the
bones, it passes over the ulnar aspect of the scaphoid reconstruction. [6]
tubercle and along a groove in the medial surface of In the case of partial ruptures, management with
the trapezium. Two laminae (superficial and deep) of the immobilization has been reported to successfully
transverse carpal ligament enclose the FCR tendon. The treat pain. Given the association of FCR rupture and
[7]
superficial lamina inserts on tubercle of the scaphoid osteoarthritis, severe and localized pain has been
and trapezium while the deep inserts on the medial lip described to be worse than rupture of other tendons of
of the groove of the trapezium. The tendon passes the wrist. [8]
[1]
through the scaphotrapezial joint line to insert at the
base of the second metacarpal. The course of the tendon Rupture of the tendon of the FCR is rare. Our case as
over the scaphotrapezial joint is of importance because well as the literature review demonstrates that long-term
of the increased incidence of rupture associated with disability following FCR rupture is minimal. Although,
scaphotrapezial osteoarthritis. [1] commonly associated with scaphotrapezial osteoarthritis,
our case demonstrates that rupture secondary to trauma
In the English and French literature, 11 cases of closed is possible and should be considered in the differential
spontaneous ruptures of the FCR tendon are described. diagnosis of pain and swelling on the flexor surface of the
Five cases of rupture were associated with a severe wrist and forearm.
rheumatoid collapse. These cases were treated
[2]
operatively with debridement and synovectomy, but no
tendon repair. In 5 cases, STT osteoarthritis was the cause REFERENCES
of the tendon rupture. In STT, osteoarthritis osteophytes
extend from the joint and during extension can damage 1. Chen PJ, Liu AL. Concurrent flexor carpi radialis tendon rupture and closed
distal radius fracture. BMJ Case Rep 2014;10:2014.
the FCR tendon sheath. In these cases, no tendon repair 2. Polatsch DB, Foster LG, Posner MA. An unusual rupture of the flexor carpi
was done as there was minimal functional impairment. radialis tendon: a case report. Am J Orthop (Belle Mead NJ) 2006;35:141‑3.
[2]
One case of FCR rupture secondary to fracture of the distal 3. Allred DW, Rayan GM. Flexor carpi radialis tendon rupture following chronic
radius was described. [3] wrist osteoarthritis: a case report. J Okla State Med Assoc 2003;96:211‑2.
4. DiMatteo L, Wolf JM. Flexor carpi radialis tendon rupture as a complication
In the majority of cases, FCR rupture is a clinical of a closed distal radius fracture: a case report. J Hand Surg Am
diagnosis. Patients present with pain at the ruptured 5. 2007;32:818‑20.
Low TH, Hales PF. High incidence and treatment of flexor carpi radialis
ends of the tendon. Palpation may reveal a gap tendinitis after trapeziectomy and abductor pollicis longus suspensionplasty
[4]
along the course of the FCR. X-ray or computed for basal joint arthritis. J Hand Surg Eur Vol 2014;39:838‑44.
tomography (CT) may be useful in determining the 6. Tonkin MA, Stern HS. Spontaneous rupture of the flexor carpi radialis tendon.
etiology of the rupture if bony spurs associated with 7. J Hand Surg Br 1991;16:72‑4.
Bowe A, Doyle L, Millender LH. Bilateral partial ruptures of the flexor carpi
osteoarthritis are suspected. radialis tendon secondary to trapezial arthritis. J Hand Surg Am 1984;9:738‑9.
Complete rupture of the FCR tendon is generally 8. Ducharne G, Frick L, Schoofs M. Flexor carpi radialis tendon rupture
following percutaneous osteosynthesis of the scaphoid: a case report. Chir
conservative, as the deficit is relatively minor. Good Main 2009;28:50‑2.
[2]
functional results have been reposted from simple
splinting. Occupational therapy is considered the
[5]
standard of treatment and consists of active and passive How to cite this article: Kanevsky J, Zammit D, Brutus JP. Rupture
range of motion exercises after 3 weeks of splinting. of the flexor carpi radialis tendon secondary to trauma: case report and
literature review. Plast Aesthet Res 2015;2:138-9.
Functional problems after tendon rupture are minimal,
and retraction of the tendon stump often makes Source of Support: Nil, Conflict of Interest: None declared.
reattachment difficult. In fact, the FCR is a useful Received: 11-11-2014; Accepted: 27-02-2015
[5]

Plast Aesthet Res || Vol 2 || Issue 3 || May 15, 2015 139