Extensor tendon involvement in Smith's and Galeazzi's fractures.

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Traumatology

Background:

• Smith's fractures and Galeazzi's fractures are distinct types of distal radius fractures.
• Extensor tendon involvement is a recognized but less common complication of these fractures.
• Understanding the patterns of tendon injury is crucial for effective management.

Observation:

• This report details five cases of extensor tendon involvement in conjunction with Smith's and Galeazzi's fractures.
• Observed injuries included entrapment, rupture, and piercing of extensor tendons by fracture fragments.
• Specific tendons affected were the extensor indicis proprius, extensor digitorum communis, extensor carpi ulnaris, and extensor digiti minimi.

Findings:

• In Smith's fractures, tendons were entrapped or ruptured, leading to a tenodesis effect on the index finger and thumb.
• One Smith's fracture case involved tendon entrapment beneath a displaced fragment, preventing closed reduction.
• In Galeazzi's fractures, tendons were trapped between displaced ulnar head fragments and the radius or styloid process.

Implications:

• Extensor tendon involvement can significantly complicate fracture management, potentially hindering closed reduction.
• These injuries can result in functional deficits, such as tenodesis, affecting finger and thumb mobility.
• Early recognition and appropriate surgical treatment are essential for optimal outcomes in these complex fractures.