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題 名 | Steroid Injection-Related Iatrogenic Rupture of Flexor Pollicis Longus Tendon--Case Report and Review of Literature=醫源性類固醇注射導致屈拇長肌肌腱斷裂--一個病例報告及文獻回顧 |
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作 者 | 林進達; 陳世宜; 陳錫根; 張舜程; 陳天牧; | 書刊名 | 臺灣整形外科醫學會雜誌 |
卷 期 | 20:4 2011.12[民100.12] |
頁 次 | 頁324-329 |
分類號 | 416.615 |
關鍵詞 | 類固醇注射; 屈拇長肌; 肌腱斷裂; Steroid injection; Flexor pollicis longus; Iatrogenic tendon rupture; |
語 文 | 英文(English) |
中文摘要 | 背景:長效型的類固醇注射用在治療肌腱病變是一種簡單且普遍的做法,卻可能會因為注射不當或長期使用造成肌腱病變,而導致肌腱斷裂。目的及目標:藉由這個類固醇注射直接導致屈拇長肌肌腱斷裂之病例報告,探討文獻上可能的受傷機轉及後續的治療。材料及方法:一位60歲男性病患因為左手腕慢性疼痛,服藥效果不善,至診所施打長效型類固醇,打完後前兩天有短暫疼痛緩解,隨後又開始感覺劇痛且左手拇指指間關節無法彎曲。經病史詢問、理學檢查及超音波診斷為屈拇長肌肌腱斷裂,於是安排手術治療。我們移植同側掌長肌肌腱來重建屈拇長肌肌腱。結果:病患術後恢復良好,屈拇長肌肌腱之病理報告顯示為慢性發炎,手術一個月後,病患的左手拇指指間關節可以主動彎曲至五十度。結論:藉由這個病例,我們建議臨床上如果遇到病患曾經施打過類固醇,且合併有拇指指間關節無法彎曲時,有可能是屈拇長肌肌腱斷裂。而且斷裂的肌腱如果未能及時診斷出來做手術直接縫合,使用掌長肌肌腱來重建是一種有效的治療方式。 |
英文摘要 | Background:Local injection of long-acting corticosteroid solution is an easy and common treatment for tendinopathies. It may result in tendon rupture due to repeated direct injuries or chronic debility with tendon ischemia and decrease of mechanical strength.Aim and objectives:We report a case of rupture of the FPL tendon after corticosteroid injection for chronic wrist pain. A literature review of possible mechanisms and current treatments of spontaneous tendon rupture are discussed.Materials and Methods:A 60-year-old male presented to our hospital with disability of flexion over Inter-Phalangeal Joint (IPJ) of left thumb for three weeks after corticosteroid injection. We harvested ipsilateral palmar longus (PL) tendon graft for reconstruction of the FPL tendon.Results:The postoperative course was uneventful. One month later, the patient was satisfied with pain relief and the IPJ of left thumb can actively flex to 50 degree.Conclusion:We suggested that the diagnosis of tendon rupture should be considered in any patient who presents with pain and has previous local steroid injection. The patient could lead a satisfactory result without further events with early awareness of the disease and timely surgical management by direct repair, tendon grafting or tendon transfer. |
本系統中英文摘要資訊取自各篇刊載內容。