{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T22:25:38Z","timestamp":1783463138743,"version":"3.55.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":173,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Subcutaneous flexor tendon rupture in patients with rheumatoid arthritis is rare compared with extensor tendon rupture, with a reported incidence of approximately one-tenth of that of extensor tendons. The pathophysiology of flexor tendon rupture is not fully understood. We report two cases of spontaneous flexor digitorum profundus tendon rupture of the little finger in patients with rheumatoid arthritis despite low disease activity and the absence of advanced joint destruction. Both patients presented with an inability to actively flex their little fingers without any history of significant trauma. Based on magnetic resonance imaging and intraoperative findings, in Case 1, direct invasion by synovitis was identified as the cause. However, in Case 2, a small bone spur on the hook of hamate was responsible for the rupture. In both cases, the suspected causative synovium or bone spur was excised, and a tendon transfer surgery to the flexor digitorum profundus of the ring finger was performed. The postoperative outcomes were favourable, with improved total active motion and no re-rupture observed during follow-up. These cases highlight that flexor tendon rupture can occur even in patients with rheumatoid arthritis with low disease activity and without advanced joint destruction. Careful evaluation of both the local inflammatory activity and mechanical factors is essential to identify the cause of rupture and prevent re-rupture.<\/jats:p>","DOI":"10.1093\/mrcr\/rxag048","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:24:01Z","timestamp":1782127441000},"source":"Crossref","is-referenced-by-count":0,"title":["Spontaneous flexor digitorum profundus tendon rupture of the little finger in patients with rheumatoid arthritis: A report of two cases with different mechanisms"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4560-733X","authenticated-orcid":false,"given":"Kaname","family":"Ohashi","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Okubo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinji","family":"Tsuchida","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryo","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"2026070718014527900_ref1","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S0363-5023(87)80151-X","article-title":"Tendon ruptures in the rheumatoid hand: analysis of treatment and functional results in 60 patients","volume":"12","author":"Moore","year":"1987","journal-title":"J Hand Surg Am."},{"key":"2026070718014527900_ref2","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1016\/j.jhsa.2007.06.012","article-title":"Spontaneous flexor tendon ruptures of the hand: case series and review of the literature","volume":"32","author":"Bois","year":"2007","journal-title":"J Hand Surg 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and tension in the repair of closed rupture of the flexor digitorum profundus in Zone III or IV","volume":"80","author":"Kim","year":"2018","journal-title":"Ann Plast Surg"},{"key":"2026070718014527900_ref7","doi-asserted-by":"crossref","first-page":"794","DOI":"10.3109\/14397595.2014.924193","article-title":"Spontaneous flexor tendon rupture in systemic lupus erythematosus: a case report","volume":"26","author":"Oda","year":"2016","journal-title":"Mod Rheumatol"},{"key":"2026070718014527900_ref8","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jbspin.2014.03.022","article-title":"Drug-induced tendinopathy: from physiology to clinical applications","volume":"81","author":"Kirchgesner","year":"2014","journal-title":"Joint Bone Spine"},{"key":"2026070718014527900_ref9","doi-asserted-by":"crossref","first-page":"136","DOI":"10.3109\/s101650170025","article-title":"Flexor tendon rupture in the rheumatoid wrist caused by bony spurs in the carpal tunnel","volume":"11","author":"Kobayashi","year":"2001","journal-title":"Mod Rheumatol"},{"key":"2026070718014527900_ref10","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1177\/17531934211073751","article-title":"Comparison of bridge graft and end-to-side transfer for treatment of closed rupture of the flexor tendons in the little finger","volume":"47","author":"Kuroda","year":"2022","journal-title":"J Hand Surg Eur"}],"container-title":["Modern Rheumatology Case 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