scholarly journals Bridge Plate Failure with Extensor Tendon Injury: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Rachel Lefebvre ◽  
Jessica Intravia ◽  
Lisa Cao ◽  
Alidad Ghiassi ◽  
Milan Stevanovic
Keyword(s):  
Case Report ◽  
Tendon Transfer ◽  
Plate Fixation ◽  
Extensor Tendon ◽  
Tendon Injury ◽  
Extensor Pollicis Longus ◽  
Bridge Plate ◽  
Important Relationship ◽  
Extensor Carpi Radialis ◽  
Plate Failure

Background. Dorsal spanning plate fixation is an increasingly popular method of fixation for certain distal radius fractures. Published outcomes are encouraging, but complications are still reported. Methods. We present a case report of a 26-year-old woman with spanning plate breakage and extensor pollicis longus (EPL) metallosis, fraying, and near-complete rupture. The patient’s unsuccessful follow-up led to this complication. Metallosis and damage to the extensor indices (EI) and distal extensor carpi radialis longus (ECRL) were intraoperative obstacles for tendon transfer to restore EPL function. Results. Tendon transfer in the setting of bridge plate failure has not yet been described in the literature. There are reports of spanning plate failure indicating that breakage often happens through the plate’s holes and after fracture healing. Conclusions. The compounded complication of plate failure with extensor tendon injury emphasizes the important relationship between the local anatomy, barriers to patient care, and potential problems after spanning plate fixation.

scholarly journals Drill Penetration Injury to Extensor Tendons: A Biomechanical Analysis

Hand ◽  
2016 ◽  
Vol 12 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Jared M. Mahylis ◽  
Anora K. Burwell ◽  
Laura Bonneau ◽  
Lynn M. Marshall ◽  
Adam J. Mirarchi
Keyword(s):  
Cyclic Loading ◽  
Plate Fixation ◽  
Extensor Tendon ◽  
Tendon Injury ◽  
Biomechanical Analysis ◽  
Extensor Pollicis Longus ◽  
Extensor Tendons ◽  
Fresh Frozen ◽  
Increasing Cyclic Loading ◽  
Extensor Carpi Radialis

Background: Little is known about extensor tendon failure following drill injury at the time of volar plate fixation. Our goals were to analyze extensor tendon injury following simulated drill penetration, and change in tendon displacement during cyclic loading following simulated drill penetration injury. Methods: Extensor pollicis longus (EPL) and extensor carpi radialis brevis (ECRB) tendons were harvested from 9 fresh frozen cadaveric arms. Eighteen EPL and 18 ECRB samples were created from harvested tendons. Drill penetration injury was performed in either a continuous or an oscillating mode. Injured tendons were subjected to 1200 cycles at 1- to 15-kg cyclic load at a frequency of 1 Hz, and analyzed for failure at drill sites and change in displacement throughout the testing cycle. Results: Ten EPL samples and 16 ECRB samples completed testing without failure. Tendon type (ECRB, EPL), mode of injury (continuous, oscillating), and location (proximal, distal) did not affect tendon displacement during loading. A single EPL tendon failed following continuous drill penetration injury. Extensor carpi radialis brevis samples had a mean change in displacement of 2.8 (standard deviation [SD]: 1.5 mm) and 5.9 mm (SD: 4.7 mm) for oscillating and continuous modes, respectively. Six EPL samples had a mean change in displacement of 4.7 (SD: 2.7 mm) and 4.3 mm (SD: 1.8 mm) for oscillating and continuous modes, respectively. Conclusions: Complete extensor tendon failure due to drill penetration was rare. Drill mode did not affect the degree of elongation. Increasing cyclic loading of extensor tendons after drill injury caused modest extensor tendon elongation.

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 An Unusual Mode of Extensor Tendon Injury – A Case Report

2020 ◽  
Vol 6 (2) ◽  
pp. 50-53
Author(s):  
Imran Ahmad ◽  
Lalit Agrawal ◽  
Khurram MF ◽  
Naveen Khubchandani
Keyword(s):  
Case Report ◽  
Extensor Tendon ◽  
Tendon Injury

ACUTE RUPTURE OF EXTENSOR POLLICIS LONGUS TENDON DUE TO AVULSED FRACTURE OF THE SECOND METACARPAL BASE: A CASE REPORT

Hand Surgery ◽  
2006 ◽  
Vol 11 (01n02) ◽  
pp. 43-45 ◽  
Author(s):  
Kazunari Ishida ◽  
Hiroyuki Fujioka ◽  
Ryoichi Doi
Keyword(s):  
Case Report ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tendon Rupture ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Acute Rupture ◽  
End To End ◽  
Extensor Carpi Radialis ◽  
Extensor Pollicis Longus Tendon

Acute tendon rupture of the extensor pollicis longus (EPL) is rare. We present acute EPL tendon rupture associated with avulsed fracture of the second metacarpal at the insertion of extensor carpi radialis longus. Tendon rupture of the EPL was repaired with end-to-end suture and avulsed fracture of the second metacarpal base was treated with open reduction and internal fixation.

scholarly journals Evaluation of Extensor Pollicis Brevis as a Recipient of Tendon Transfer for Thumb Extension

2019 ◽  
Vol 52 (02) ◽  
pp. 171-177 ◽  
Author(s):  
Praveen Bhardwaj ◽  
Poonacha Puchimada Muddappa ◽  
Dadi Bindesh ◽  
Shanmuganathan Raja Sabapathy
Keyword(s):  
Tendon Transfer ◽  
Anatomical Variation ◽  
Excellent Result ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Radial Nerve Palsy ◽  
Brachial Plexus Palsy ◽  
Extensor Pollicis Longus ◽  
Extensor Pollicis Brevis ◽  
Flexor Carpi Ulnaris

Abstract Introduction Rerouting of the extensor pollicis longus (EPL) is the standard part of tendon transfer surgery for thumb extension. It is done to overcome the ulnar vector of the EPL action. Extensor pollicis brevis (EPB), however, produces better thumb abduction and extension by virtue of its radial vector. The described anatomical variation of EPB extending the thumb interphalangeal joint (IPJ), therefore, gives the “best combination” of movements by a single-thumb extensor tendon. Materials and Methods We performed this transfer in six patients in whom the EPB was found to be extending the IPJ while checked intraoperatively. Three of these six patients were cases of radial nerve palsy and the other three presented with brachial plexus palsy. The outcome was assessed by measuring palmar and radial abduction of the thumb, Kapandji’s score, and Bincaz’s scale. Results We found satisfactory results in all the six patients. In our series, patients had an average radial extension of the thumb of 29.2 degrees and an average palmar abduction of the thumb of 65.7 degrees. On evaluation with the Bincaz score; one patient had excellent result, three patients had good results, and two patients had fair results. Conclusion In situations where EPL rerouting is not possible (as in cases where the donor tendon needs to reach the thumb from the ulnar side, for example, flexor carpi ulnaris), transfer to the EPB, provided it is extending the thumb IPJ, would produce better extension and abduction of the thumb than the transfer to the EPL.

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