Scaphoid nonunion and flexor pollicis longus tendon rupture

Four patients presented with a rupture of the flexor pollicis longus tendon that was associated with a longstanding scaphoid nonunion. A radiocarpal a rthrosis was present in 3 of the 4 patients and a dorsiflexed intercalated segment instability deformity was also seen in 3 of the 4 patients. Three p atients underwent surgery consisting of an osteosynthesis with an iliac bon e graft for the scaphoid nonunion and a palmaris longus tendon graft for th e ruptured flexor pollicis longus tendon. An osseous union of the scaphoid and a functional active range of motion of the thumb interphalangeal joint (33 degrees on average) was attained in all 3 of the patients treated surgi cally. Preoperative radiologic examinations and intraoperative findings sug gest that the volarly protruding distal scaphoid segment is the cause of th e rupture. (J Hand Surg 1999;24A:1211-1219. Copyright (C) 1999 by the Ameri can Society for Surgery of the Hand.)