Jun-Ku Lee; In-Tae Hong; Young-Woo Kwon; Gyu-Chol Jang; Soo-Hong Han

doi:10.12671/jkfs.2017.30.2.63

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Original Article
Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture: Jun-Ku Lee, M.D., In-Tae Hong, M.D., Young-Woo Kwon, M.D., Gyu-Chol Jang, M.D., Soo-Hong Han, M.D., Ph.D.; Journal of the Korean Fracture Society 2017;30(2):63-68.
DOI: https://doi.org/10.12671/jkfs.2017.30.2.63
Published online: April 18, 2017

Department of Orthopaedic Surgery, CHA Bundang Medical Center, School of Medicine, CHA University, Seongnam, Korea.

Correspondence to: Soo-Hong Han, M.D., Ph.D. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea. Tel: +82-31-780-5289, Fax: +82-31-708-3578, hsoohong@hanmail.net

Jun-Ku Lee's current affiliation: Department of Orthopedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

• Received: October 9, 2016 • Revised: January 15, 2017 • Accepted: February 18, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The spontaneous extensor pollicis longus (EPL) tendon rupture is a well-documented complication of non-displaced or minimally displaced distal radius fracture. Authors analyzed the radiographs of patients treated for closed EPL rupture after distal radius fracture.
Materials and Methods
Twenty-eight patients (21 females, 7 males; average age of 58 years) with tendon transfer for spontaneous rupture of EPL after distal radius fracture were included. Wrist radiographs were taken at the first visit with EPL rupture. On the lateral view, posterior cortical displacement, distance from highest point in Lister's tubercle to fracture line, and height of the Lister's tubercle were measured. The distance from the lunate facet to the fracture line was measured on anteroposterior view. Radiologic change at the time of EPL rupture around the Lister's tubercle was evaluated by comparing it with the contra lateral wrist radiograph. Radial beak fracture pattern was also identified.
Results
The interval between the injury and the spontaneous EPL rupture varied from 2 to 20 weeks, with an average of 6.7 weeks. There were 25 cases of non-displacement, 3 cases of mean 2.0 mm cortical displacement. The average distance from the lunate facet to the fracture line was 9.1 mm (3-12.1 mm), from the highest point in Lister's tubercle to the fracture line was 3.0 mm toward proximal radius (1.7-4.9 mm). The average height of the Lister's tubercle was 3.4 mm in the injured wrist and 3.1 mm in the opposite wrist. Radial beak fracture pattern was shown at 11 cases.
Conclusion
All cases presented no or minimal displaced fracture, and the fracture line was in the vicinity of the Lister's tubercle. Those kinds of fractures can highlight the possibility of spontaneous EPL rupture, depites its rarity.
Key words: Distal radius fracture, Extensor pollicis longus, Rupture, Lister's tubercle, Radiologic analysis

None.

REFERENCES

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Fig. 1

Flow sheet depicts history (Hx) of study patients (pts).

Fig. 2

Distance to Fracture line is measured from lunate facet to fracture line.

Fig. 3

Height of the Lister's tubercle is measured from the dorsal aspect of the radial metaphysis to the highest point in the Lister's tubercle.

Fig. 4

Distance from Lister's tubercle to the fracture line is measured from the highest point in Lister's tubercle to the fracture line.

Fig. 5

Radial beak fracture pattern shows that the fracture line deviates from transverse to proximal at the radial side.

Table 1

Descriptive Values of Patients (n=28)

Characteristic	Value
Mean age (yr)	57.6 (16–80)
Gender
Male	21 (75.0)
Female	7 (25.0)
Injured wrist
Right	13 (46.4)
Left	15 (53.6)
Interval from trauma (wk)	6.7 (2–20)
Injury mechanism
Falls from standing height	21 (75.0)
Falls from a greater height	2 (7.1)
Obscure	5 (17.9)

Values are presented as median (range) or number (%).

Table 2

Fractures Included in Analysis

Evaluation factor	Length (mm)	Remark	p-value
Distance from lunate facet to fracture line	9.1
The height of the Lister's tubercle	3.4	Normal (mm): 3.1 (11 cases)	0.199
Distance from Lister's tubercle to Fracture line	3.0	Range (mm): 1.7–4.9
Radial beak fracture		11 cases

Figure & Data

REFERENCES

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Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture

J Korean Fract Soc. 2017;30(2):63-68. Published online April 30, 2017

DOI: https://doi.org/10.12671/jkfs.2017.30.2.63

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Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture

Fig. 1 Flow sheet depicts history (Hx) of study patients (pts).

Fig. 2 Distance to Fracture line is measured from lunate facet to fracture line.

Fig. 3 Height of the Lister's tubercle is measured from the dorsal aspect of the radial metaphysis to the highest point in the Lister's tubercle.

Fig. 4 Distance from Lister's tubercle to the fracture line is measured from the highest point in Lister's tubercle to the fracture line.

Fig. 5 Radial beak fracture pattern shows that the fracture line deviates from transverse to proximal at the radial side.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Fig. 5

Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture

Table 1

Descriptive Values of Patients (n=28)

Characteristic	Value
Mean age (yr)	57.6 (16–80)
Gender
Male	21 (75.0)
Female	7 (25.0)
Injured wrist
Right	13 (46.4)
Left	15 (53.6)
Interval from trauma (wk)	6.7 (2–20)
Injury mechanism
Falls from standing height	21 (75.0)
Falls from a greater height	2 (7.1)
Obscure	5 (17.9)

Values are presented as median (range) or number (%).

Table 2

Fractures Included in Analysis

Evaluation factor	Length (mm)	Remark	p-value
Distance from lunate facet to fracture line	9.1
The height of the Lister's tubercle	3.4	Normal (mm): 3.1 (11 cases)	0.199
Distance from Lister's tubercle to Fracture line	3.0	Range (mm): 1.7–4.9
Radial beak fracture		11 cases

Table 1 Descriptive Values of Patients (n=28)

Values are presented as median (range) or number (%).

Table 2 Fractures Included in Analysis