Flexor Pollicis Longus Tendon Rupture after Distal Radius Volar Plating and Reconstruction with Interpositional...

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Research
• Hand Surgery

Background:

• Distal radius fractures are common, with volar locking plates as a standard treatment.
• Complications include flexor pollicis longus (FPL) tendon rupture due to hardware irritation.
• Managing FPL rupture after volar plating is challenging due to tendon attrition and surgical access issues.

Observation:

• A 62-year-old female experienced acute loss of thumb flexion 5 months post-distal radius volar locking plate fixation.
• Evaluation revealed FPL tendon rupture without new trauma.
• The patient underwent hardware removal and FPL reconstruction using a palmaris tendon autograft.

Findings:

• This case report details the first use of an interpositional palmaris tendon autograft for FPL tendon rupture secondary to volar locking plate fixation.
• The technique involved concurrent hardware removal and tendon reconstruction.
• The procedure aimed to restore thumb flexion function.

Implications:

• This interpositional palmaris tendon graft technique is proposed as a viable option for FPL tendon rupture post-distal radius volar plating.
• Further research may validate this approach for similar challenging cases.
• This method addresses a significant complication in distal radius fracture management.