PMC2852763_01
The patient was unable to fully extend the right metacarpophalangeal (MCP) joint.
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Upon physical examination, his hands appeared normal except that he was unable to actively extend the right MCP joint (Figure 1).
View of the XP photograph of the hand. No abnormalities are evident.
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Radiographs were normal (Figure 2).
There was no tenderness, swelling, or redness in either hand. The extensor pollicis brevis (EPB) tendon could not be palpated (arrow-head), however. White arrow-head = EPB tendon; black arrow-head = abductor pollicis longus (APL) tendon.
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Although there were no tenderness, swelling, or redness in the right hand, the extensor pollicis brevis (EPB) tendon could not be palpated (Figure 3), and the diagnosis of spontaneous rupture of the EPB tendon was made.
The hypoplastic extensor pollicis brevis (EPB) tendon was found ruptured at the level of the carpometacarpal joint of the right hand. The proximal part of the tendon was absent (arrow-head). The extensor indicis proprius (EIP) was transferred to the base of the proximal phalanx. White arrow-head = EPB tendon; black arrow-head = abductor pollicis longus (APL) tendon; black arrow = EIP tendon.
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At operation, a hypoplastic EPB tendon was found ruptured at the level of the carpometacarpal joint of the right hand (Figure 4). Consequently, an extensor indicis proprius (EIP) tendon transfer was carried out (Figure 4).
At 6 weeks after the operation, the patient had full range of movement of his right thumb.
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Six weeks after the operation, the patient had full-range movement of his right thumb (Figure 5) and index finger.