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Spontaneous rupture of the extensor pollicis longus tendon
D Siegel1, M Gebhardt, J B Jupiter
1Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston 02114.
The Journal of Hand Surgery
|November 1, 1987
Summary
Rupture of the extensor pollicis longus tendon after giant cell tumor treatment was successfully managed with extensor indicis proprius tendon transfer. This procedure restored thumb extension, addressing a complication of distal radius tumor management.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Oncology
Background:
- Giant cell tumors of the distal radius can necessitate surgical intervention, including bone cavity packing.
- Polymethylmethacrylate cement is sometimes used for bone defect reconstruction after tumor removal.
- Tendon integrity can be compromised by adjacent surgical procedures and materials.
Observation:
- A patient experienced rupture of the extensor pollicis longus tendon following treatment for a distal radius giant cell tumor.
- The rupture occurred after the tumor cavity was packed with polymethylmethacrylate cement.
- This resulted in a loss of thumb extension (lack of extension).
Findings:
- The extensor pollicis longus tendon rupture was successfully treated using a tendon transfer procedure.
- The extensor indicis proprius tendon was transferred to reconstruct the function of the extensor pollicis longus.
- Restoration of thumb extension was achieved post-transfer.
Implications:
- Tendon transfer is an effective surgical option for managing extensor pollicis longus tendon rupture secondary to distal radius tumor treatment.
- Understanding the pathophysiology of cement-induced tendon rupture is crucial for preventing such complications.
- This case highlights the importance of considering tendon viability and biomechanics in oncological reconstructions of the distal radius.