Risk of the Repeated Local Steroid Injection: Rupture of the Extensor Mechanism at Zone V

Park,  Jin Sung; Lee,  Dong Yeong; Hwang,  Sun Chul; Nam,  Dae Cheol

doi:2015.20.3.142

Arch Hand Microsurg > Volume 20(3); 2015 > Article

Case Report

Journal of the Korean Society for Surgery of the Hand 2015;20(3):142-147.
Published online September 30, 2015.
DOI: https://doi.org/10.12790/jkssh.2015.20.3.142

Risk of the Repeated Local Steroid Injection: Rupture of the Extensor Mechanism at Zone V

Jin Sung Park, Dong Yeong Lee, Sun Chul Hwang, Dae Cheol Nam

Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea. ortho87@naver.com

Received: 30 March 2015 • Revised: 23 July 2015 • Accepted: 23 July 2015

Abstract

Indicators for local steroid injection on the hands include trigger finger, De Quervain's disease, carpal tunnel syndrome and trapeziometacarpal joint arthritis. Local steroid injection is an effective technique for rapid alleviation of symptoms and return to daily life. Complications following local steroid injection include depigmentation of the skin, subcutaneous fat atrophy, infection and tendon rupture. Tendon rupture and infection rarely occur as severe complications, and local steroid injection should not be abused or misused. The authors experienced a rupture of the extensor mechanism at extensor zone V after repeated local steroid injection to treat vague pain in the second metacarpophalangeal joint, followed by reconstruction of the extensor mechanism through tendon transfer and sagittal band reconstruction. We herein report a case with the literature review.