Rupture of the Flexor Pollicis Longus Tendon from the Metacarpophalangeal Sesamoid and Joint in a Rheumatoid Patient: A Case Report

JBJS Case Connect. 2023 May 5;13(2). doi: 10.2106/JBJS.CC.22.00747. eCollection 2023 Apr 1.


Case: A 54-year-old woman with rheumatoid arthritis presented with a flexor pollicis longus (FPL) rupture at the level of the metacarpophalangeal joint secondary to attritional damage from metacarpophalangeal (MCP) degenerative changes and exostoses from the radial sesamoid. She underwent direct tendon repair with debridement of the MCP joint and radial sesamoidectomy.

Conclusion: Rheumatoid arthritis can potentially lead to rupture of the FPL tendon in locations distal to the carpus, namely at the level of the MCP joint. Contrary to other reports, a quality outcome may be obtained with direct repair and may not necessarily require tendon transfer, fusion, or grafting.

Publication types

  • Case Reports

MeSH terms

  • Arthritis, Rheumatoid* / complications
  • Arthritis, Rheumatoid* / surgery
  • Female
  • Humans
  • Middle Aged
  • Rupture / complications
  • Tendon Injuries* / complications
  • Tendon Injuries* / surgery
  • Tendons
  • Thumb
  • Wrist