作者：Ching-Hsuan Hu, Duretti Fufa, Chung-Chen Hsu, Yu-Te Lin, Chih-Hung Lin.
文章發表：Hand (N Y). 2015 Dec;10(4):726-31
作者：Ching-Hsuan Hu, Duretti Fufa, Chung-Chen Hsu, Yu-Te Lin, Chih-Hung Lin. 文章發表：Hand (N Y). 2015 Dec;10(4):726-31 大綱：在橈骨遠端骨折，慢性關節炎，類固醇注射後，有過度伸張或重複性活動，會導致伸拇長肌（EPL）肌腱斷裂。很少有自發性EPL破裂而無明顯誘因的報導。
方法：我們採回顧性研究分析了在長庚醫院接受治療的8例自發性EPL破裂患者。
結果：大多數病例為女性（75％，n = 6），而在手部占主導地位（75％，n = 6）最常見。在四名患者中沒有發現可識別的誘發因素。雖然有四名患者報告有跌倒史，但放射線照相未能在所有四例中顯示出骨骼異常。手術時未發現其他病理原因。使用肌腱轉移術（n = 7）或介入植入物（n = 1）進行治療。在平均74.8個月（23-140個月）的追蹤期內，沒有臨床復發病例。結論：即使沒有明確的易患危險因素，EPL肌腱也有自發斷裂的危險。血管和代謝因子以及機械式刺激(即感受壓力、變形等力學性刺激)，而是在這種罕見診斷的病因中起著重要作用。
Introduction
Rupture of the extensor pollicis longus (EPL) tendon has been reported in the setting of distal radius fracture, chronic inflammatory arthritis, following steroid injection, and with excessive or repetitive activities. Truly, spontaneous EPL rupture, without an identifiable predisposing factor, has rarely been reported.
Methods
We present a retrospective case series of eight patients with spontaneous EPL rupture who were treated in our institution.
Results
The majority of the cases were female (75 %, n = 6), and the nondominant (75 %, n = 6) hand was most commonly involved. No identifiable predisposing factor could be identified in four patients. While four patients reported a history of a fall, radiographs failed to demonstrate skeletal abnormality in all four cases. No additional pathology could be identified at the time of surgery. Patients were treated using tendon transfer (n = 7) or interpositional graft (n = 1). There has been no case of clinical recurrence in the mean of 74.8 months (range 23–140 months) follow-up period.
Conclusion
The EPL tendon is at risk for spontaneous rupture even in the absence of identifiable predisposing risk factor. Rather than pure mechanical irritation, vascular and metabolic factors may also play a substantial role in the etiology of this uncommon diagnosisn.
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