Gouty Tophi within the Carpal Tunnel Leading to Severe Finger Flexion Contracture A Case Report and Short-Term Follow-Up

BACKGROUND: It is rare for tophi to invade the carpal tunnel and cause finger flexion deformity. It is often misdiagnosed or delayed in treatment, seriously affecting hand function. CASE SUMMARY: This article reports a 47-year-old male patient who presented with a mass on the palmar side of his right wrist and ring finger flexion deformity. Imaging and intraoperative findings revealed that tophi extensively involved the flexor tendon and caused tendon adhesion and carpal tunnel entrapment. Through surgical removal of tophi, loosening of adhesions, and decompression of the carpal tunnel, as well as continuous post-operative uric acid-lowering treatment, the patient's hand function recovered significantly. CONCLUSION: Based on the literature review, it is suggested that for unexplained hand deformities, we need to be alert to the possibility of tophi. Early diagnosis and comprehensive treatment can improve the prognosis.