Nam-Young Cho; Chang-Young Seo; Myung-Sun Kim; Ha-Sung Kim; Keun-Bae Lee

doi:10.12671/jkfs.2012.25.1.52

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Original Article
Extensor Pollicis Longus Rupture after Distal Radius Fracture: Nam-Young Cho, M.D., Chang-Young Seo, M.D., Myung-Sun Kim, M.D., Ha-Sung Kim, M.D., Keun-Bae Lee, M.D., Ph.D.; Journal of the Korean Fracture Society 2012;25(1):52-57.
DOI: https://doi.org/10.12671/jkfs.2012.25.1.52
Published online: January 31, 2012

Department of Orthopaedic Surgery, Chonnam National University Medical School, Gwangju, Korea.

Address reprint requests to: Chang-Young Seo, M.D. Department of Orthopaedic Surgery, Chonnam National University Hospital, 671, Jebong-ro, Dong-gu, Gwangju 501-757, Korea. Tel: 82-62-220-6336, Fax: 82-62-225-7794, scy1art@naver.com

• Received: November 1, 2011 • Accepted: November 16, 2011

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Abstract
REFERENCES

Abstract

Purpose
To evaluate the cause and surgical outcome of extensor pollicis longus rupture after distal radius fractures.
Materials and Methods
Nineteen cases in which the patients underwent surgical treatment for rupture of the extensor pollicis longus after distal radius fractures were followed for more than one year. Among the nineteen cases, fourteen extensor pollicis longus ruptures occurred after conservative treatment, four occurred after closed reduction with K-wire fixation, and one occurred after open reduction and internal fixation with a plate. All cases were treated by extensor indicis proprius transfer.
Results
Extensor pollicis longus ruptures were caused by K-wire irritation in two, by a protruding screw tip in one, and by a callus in one. In the conservative treatment group, tendon ruptures were diagnosed at an average of 3.1 months (0.7~17). Tendon ruptures were detected in the surgical treatment group at an average of 12.8 months (1~48). All the patients showed favorable recovery of the extension capability of the thumb at the final follow-up.
Conclusion
The main cause of extensor pollicis longus rupture after distal radius fracture was ischemic damage. Therefore, during the surgery, the length and direction of screws and K-wires should be fixed carefully to avoid such damage. Distal radius fracture also requires careful observation of the extensor pollicis longus during follow-up. Furthermore, extensor indicis proprius transfer is considered to be an effective method for extensor pollicis longus rupture.
Key words: Distal radius fracture, Extensor pollicis longus rupture

REFERENCES

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Fig. 1

(A, B) Plain radiographs in 78 year-old female patient showed successful union with multiple K-wires fixation at 3 months after distal radius fracture surgery.

(C, D) Extensor pollicis longus (white arrow) was mechanically irritated by K-wire (black arrow).

Fig. 2

(A, B) Plain radiographs in 51 year-old female patient showed successful union with volar locking plate at 2 months after distal radius fracture surgery.

(C) Extensor pollicis longus was mechanically irritated by protruded screw tip (black arrow).

Table 1

Demographic data

Table 2

Classification of results by Riddell18)

Table 3

Patient demographics and outcomes

AO: Arbeitsgemeinschaft für Osteosynthesefragen, EPL: Extensor pollicis longus, EI: Extensor indicis, F: Female, M: Male, K-wire: Kirschner-wire.

Figure & Data

REFERENCES

Citations

Citations to this article as recorded by

Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture
Jun-Ku Lee, In-Tae Hong, Young-Woo Kwon, Gyu-Chol Jang, Soo-Hong Han
Journal of the Korean Fracture Society.2017; 30(2): 63. CrossRef
Assessment of penetration of dorsal screws after fixation of the distal radius using ultrasound: cadaveric study
D Williams, J Singh, N Heidari, M Ahmad, A Noorani, L Di Mascio
The Annals of The Royal College of Surgeons of England.2016; 98(2): 138. CrossRef
Rupture of the Extensor Pollicis Longus Tendon at the Proximal Screw of Volar Plate Fixation for Distal Radius Fracture - A Case Report -
Dong-Ju Shin, Seung-Oh Nam, Hun-Sik Cho
Journal of the Korean Fracture Society.2013; 26(4): 338. CrossRef

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Extensor Pollicis Longus Rupture after Distal Radius Fracture

J Korean Fract Soc. 2012;25(1):52-57. Published online January 31, 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.1.52

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Figure

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Extensor Pollicis Longus Rupture after Distal Radius Fracture

Fig. 1 (A, B) Plain radiographs in 78 year-old female patient showed successful union with multiple K-wires fixation at 3 months after distal radius fracture surgery. (C, D) Extensor pollicis longus (white arrow) was mechanically irritated by K-wire (black arrow).

Fig. 2 (A, B) Plain radiographs in 51 year-old female patient showed successful union with volar locking plate at 2 months after distal radius fracture surgery. (C) Extensor pollicis longus was mechanically irritated by protruded screw tip (black arrow).

Fig. 1

Fig. 2

Extensor Pollicis Longus Rupture after Distal Radius Fracture

Table 1

Demographic data

Table 2

Classification of results by Riddell18)

Table 3

Patient demographics and outcomes

AO: Arbeitsgemeinschaft für Osteosynthesefragen, EPL: Extensor pollicis longus, EI: Extensor indicis, F: Female, M: Male, K-wire: Kirschner-wire.

Table 1 Demographic data

Table 2 Classification of results by Riddell18)

Table 3 Patient demographics and outcomes

AO: Arbeitsgemeinschaft für Osteosynthesefragen, EPL: Extensor pollicis longus, EI: Extensor indicis, F: Female, M: Male, K-wire: Kirschner-wire.