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A case report of index flexor digitorum superficialis and flexor digitorum profundus ruptures caused by a volarly protruding fragment in advanced Kienböck disease: reconstruction with a two-strand palmaris longus tendon graft

Year: 2026

Type: article

Abstract: Spontaneous flexor tendon rupture is a rare complication of advanced Kienböck disease. A 75-year-old woman presented with progressive loss of active flexion of the left index finger. Radiography, computed tomography, and magnetic resonance imaging demonstrated Lichtman stage IIIC Kienböck disease with a volarly displaced lunate fragment breaching the volar capsule and causing complete rupture of the index flexor digitorum superficialis and flexor digitorum profundus (FDP) tendons, leaving an approximately 5-cm FDP defect. Proximal row carpectomy was performed to remove the fragmented lunate, eliminate the source of chronic attrition, and address wrist pain. The FDP defect was reconstructed using a two-strand looped palmaris longus tendon graft with a modified Pulvertaft weave. At 2 years, satisfactory functional recovery was achieved without re-rupture. Volar lunate fragmentation should be recognized as a cause of flexor tendon rupture, and computed tomography and magnetic resonance imaging are important for accurate diagnosis and surgical planning in such cases.

Source: Archives of Hand and Microsurgery

DOI: 10.12790/ahm.26.0011

Authors: Jun-Hyuk Lim, Kanghun Yu, In Cheul Choi, Jong Woong Park

Institutions: Chonnam National University, Chonnam National University Hospital, Korea University, Korea University Medical Center

Language: English

Topic: Orthopedic Surgery and Rehabilitation

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W7204137766