Abstract
The flexor tendon can be enlarged in chronic tenosynovitis, and it may sometimes trigger
flexor tendon entrapment, but there have been no reports of its evaluation on preoperative
imaging or postoperative pathologic examination. The case of a 54-year-old man who
suffered flexor tendon entrapment due to intratendinous tumor-like tissue between
the first and second annular pulleys, which was identified on magnetic resonance imaging
preoperatively, is described. Ulnar superficialis slip resection and reduction flexor
tenoplasty of flexor digitorum profundus were effective procedures for the release
of flexor tendon entrapment under wide-awake surgery with local anesthesia. On postoperative
pathologic examination, chondroid metaplasia was identified, in association with infiltration
of chondrocytes and inflammatory cells into the flexor tendon fibers and tenosynovium.
Preoperative imaging was useful in a case of chronic or severe tenosynovitis to assess
the condition of flexor tendons, and wide-awake surgery was the appropriate procedure
for the treatment of this case.
Keywords
flexor tendon entrapment - proliferative tenosynovitis - reduction flexor tenoplasty
- chondroid metaplasia
