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Small flake, big problem: an unreported cause of extensor pollicis longus tendon rupture
1Hand Management Unit, Plastic Surgery Department, Chelsea & Westminster Hospital, London, UK. charlie@thedurrants.org
Annals of the Royal College of Surgeons of England
|January 9, 2010
Summary
A rare fracture of the third metacarpal base can cause extensor pollicis longus tendon division. Early diagnosis via lateral radiographs and surgical fixation for displaced fragments are crucial for managing this uncommon hand injury.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Traumatology
Background:
- Fractures of the metacarpal base are common hand injuries.
- Avulsion fractures of the extensor carpi radialis brevis tendon are rare.
- This case highlights an unusual complication of this specific injury pattern.
Observation:
- A fracture at the base of the third metacarpal bone was identified.
- This fracture was associated with an avulsion of the extensor carpi radialis brevis tendon.
- A rare complication of division of the extensor pollicis longus tendon by the fractured bone fragment was observed.
Findings:
- The avulsed bony fragment from the third metacarpal base caused secondary division of the extensor pollicis longus tendon.
- Diagnosis of this complication requires careful monitoring with lateral radiographs.
- Displacement of the avulsed fragment necessitates surgical intervention.
Implications:
- This case underscores the importance of vigilant radiographic assessment in metacarpal base fractures.
- Prompt diagnosis and surgical management (open reduction and internal fixation) are vital for optimal outcomes.
- Understanding this rare complication can improve clinical practice in hand trauma management.
