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Extensor pollicis longus tendon ruptures after the use of volar locking plates for distal radius fractures
Yukichi Zenke1, Akinori Sakai, Toshihisa Oshige
1Department of Orthopaedic Surgery, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan , Department of Orthopaedic Surgery, Kagawa Rosai Hospital, Marugame 763-8502, Japan.
Abstract:
Currently, volar locking plates are commonly used to treat distal radius fractures (DRF) because of their stable biomechanical construct and because they cause less soft tissue disturbance and allow early mobilisation of the wrist. Complications such as rupture of tendons have been reported to occur with use of volar locking plates. We describe six cases of rupture of extensor pollicis longus (EPL) tendons after the use of volar locking plates. EPL tendon injuries occurred in 2.1% (6/286) of cases after DRF surgery. The causes of EPL rupture after DRF surgery were protrusion of the head tip and insufficient reduction of the dorsal roof fragment of the distal radius. These were considered iatrogenic problems. The cause of EPL rupture was unknown in three cases. We should be extremely careful when determining optimum screw length and reducing displaced dorsal roof fragments to prevent damaging the EPL tendons.
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