Extensor Pollicis Longus Ruptures in Distal Radius Fractures: A Clinical and Cadaveric Study with a New Therapeutic Intervention

2010 ◽  
Vol 35 (10) ◽  
pp. 19-20
Author(s):  
Andrew Putman ◽  
Gary M. Lourie ◽  
Taylor Cates ◽  
Allan E. Peljovich
Keyword(s):  
Distal Radius ◽  
Therapeutic Intervention ◽  
Cadaveric Study ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Extensor Pollicis Longus

scholarly journals Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study

2011 ◽  
Vol 93 (1) ◽  
pp. 57-60 ◽  
Author(s):  
DC Perry ◽  
DMG Machin ◽  
JA Casaletto ◽  
DJ Brown
Keyword(s):  
High Risk ◽  
Distal Radius ◽  
Plate Fixation ◽  
Tendon Injury ◽  
Distal Radius Fractures ◽  
Volar Plate ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Fixed Angle ◽  
Volar Plate Fixation

INTRODUCTION Rupture of extensor pollicis longus (EPL) tendon is a recognised complication following volar plate fixation of distal radius fractures, usually from attrition caused by prominent screws. We sought to identify the screw holes in some of the most commonly used plates which may precipitate tendon injury. SUBJECTS AND METHODS Three fixed-angle volar locking plates were sequentially positioned into 18 cadaveric arms. A wire was passed through each of the holes in the plates using a locking guide and the dorsal relationships noted. RESULTS Each plate had specific ‘high-risk’ holes which directed the wire towards the EPL groove. The central screw holes appeared mostly implicated in EPL injury. CONCLUSIONS Awareness of ‘high-risk’ holes and appropriate minor alterations in surgical technique may consequently decrease the incidence of EPL irritation and rupture.

scholarly journals Extensor Tendon Entrapment on Computed Tomography Imaging of Distal Radius Fractures

2019 ◽  
Vol 09 (02) ◽  
pp. 129-135
Author(s):  
Evan D. Nigh ◽  
Christopher P. Emerson ◽  
David To ◽  
Spencer Barnhill ◽  
Michael G. Rizzo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Distal Radius ◽  
Motor Vehicle ◽  
Ct Imaging ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Extensor Pollicis Longus ◽  
Tendon Entrapment

Abstract Objective To examine the association between distal radius fractures and tendon entrapment identified on computed tomography (CT) imaging. Patients and Methods After Institutional Review Board approval, we retrospectively reviewed distal radius fractures that underwent CT imaging from an electronic database between January 2006 to February 2018 at a single level 1 hospital trauma center. We categorized all distal radial fractures according to the AO-OTA (AO Foundation/Orthopaedic Trauma Association) classification. Distal upper extremity tendons were assessed for entrapment. Fisher's exact test was used for statistical analysis with significance at p < 0.05. Results A total of 183 distal radius fractures were identified in 179 patients. A total of 16 fractures (13 males and 3 females) were associated with tendon entrapment. Mechanism of injury included falls (n = 7), motor vehicle accidents (n = 6), dog bites (n = 2), and gunshot wound (n = 1). Entrapped tendons were limited to the extensor compartment and included the extensor pollicis longus (EPL; n = 11), extensor pollicis brevis (n = 1), extensor carpi ulnaris (n = 1), extensor carpi radialis longus (n = 1), and extensor digitorum communis (n = 2). The most commonly associated AO-OTA fracture pattern with tendon entrapment was complete articular radial fractures (2R3C; 69%), eight of which were simple articular with metaphyseal multifragmentary fractures (2R3C2). Of the distal radius fractures, 81% were associated with additional ulnar fractures of varying severity and displacement. Conclusion Approximately 8.7% of distal radius fractures were retrospectively identified to have tendon entrapment compared with a previously reported incidence of 1.3%. Wrist surgeons and radiologists should have higher suspicion for tendon entrapment and carefully review preoperative CT imaging for tendon entrapment in distal radius fractures especially if there is an intra-articular, multifragmentary injury pattern. Wrist surgeons and radiologists should also have increased suspicion for EPL tendon entrapments given its high incidence in association with distal radius fractures. Level of Evidence This is a Level III, retrospective cross-sectional study.

A survey of extensor pollicis longus tendon injury at the time of distal radius fractures

Injury ◽  
2017 ◽  
Vol 48 (4) ◽  
pp. 925-929 ◽  
Author(s):  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Thitinut Dilokhuttakarn ◽  
Mayuko Kinoshita ◽  
Kenji Goto ◽  
...  
Keyword(s):  
Distal Radius ◽  
Tendon Injury ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Extensor Pollicis Longus Tendon

Correlation of Malrotation Deformity in Distal Radius Fractures With Radiographic Analysis: Cadaveric Study

2010 ◽  
Vol 35 (2) ◽  
pp. 228-232 ◽  
Author(s):  
Steve K. Lee ◽  
Robert Shin ◽  
Alissa Zingman ◽  
Justin Loona ◽  
Martin A. Posner
Keyword(s):  
Distal Radius ◽  
Cadaveric Study ◽  
Distal Radius Fractures ◽  
Radiographic Analysis ◽  
Radius Fractures

Extensor pollicis longus tendon rupture caused by a displaced dorsal “beak” fragment of Lister’s tubercle in distal radius fractures

2019 ◽  
Vol 51 (03) ◽  
pp. 199-204 ◽  
Author(s):  
Jun-Ku Lee ◽  
Jin-Young Bang ◽  
Yun Seong Choi ◽  
Tae-Ho Kim ◽  
Woo-Jin Yu ◽  
...  
Keyword(s):  
Distal Radius ◽  
Tendon Rupture ◽  
Open Reduction Internal Fixation ◽  
Distal Radius Fractures ◽  
Dash Score ◽  
Radius Fractures ◽  
Fracture Fragment ◽  
Extensor Pollicis Longus ◽  
Closed Rupture ◽  
Initial Fracture

Abstract Introduction Ruptures of the extensor pollicis longus (EPL) tendon are a well-known complication of distal radius fractures (DRF). There are a lot of suspected mechanisms, including mechanical friction, vascular impairment, injury associated with reduction, and local adhesion. However, there have been limited reports about a closed rupture of the EPL tendon associated with a relatively large, displaced dorsal “beak” fracture fragment. We report about the management outcomes and clinical significance of closed ruptures of the EPL tendon caused by a displaced dorsal fracture fragment of beak-like appearance in DRF. Patients/Material and Methods Our study included 7 cases of a complete closed rupture of the EPL tendon after open reduction internal fixation. All cases showed a similar pattern involving a relatively large dorsal beak fragment originating from Lister’s tubercle, and we treated them with a palmar locking plate within 7 days from the initial fracture without separate dorsal fragment management. All patients were diagnosed with a delayed EPL tendon rupture. Results The study included 5 female and 2 male patients. Mean patient age was 59 years. In all cases we explored the extensor compartment III to verify the exact cause of the EPL rupture. Six patients underwent an extensor indicis transfer and one patient underwent tendon grafting.Mean fragment width and length were 7.0 mm and 13.3 mm, respectively. The fragments were dorsally elevated (mean, 2.4 mm) and distally displaced (mean, 3.5 mm). At the last follow-up, the mean DASH score was 4.4. Mean thumb MP joint flexion and extension were 4 degrees and 62 degrees, respectively. Conclusion We support the possibility of EPL tendon rupture caused by displaced sharp Lister’s tubercle fracture fragments.

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