Pediatric Extensor Pollicis Longus Rupture After Distal Radius Fracture: A Case Report

Extensor pollicis longus (EPL) tendon rupture is a significant complication following a distal radius fracture that is well reported in the adult patient population but rarely seen in the pediatric patient population. We present a delayed EPL tendon rupture in a skeletally immature patient with a minimally displaced distal radius fracture and aim to highlight the importance of prompt diagnosis and appropriate management of this uncommon complication. We report a case of a 14-year-old female who presented with a Salter-Harris type II fracture of the distal radius with 10 degrees of dorsal angulation. Following non-operative treatment with brace immobilization, the patient presented at four weeks with an atraumatic rupture of her EPL tendon. Subsequently, she underwent extensor indicis proprius (EIP) transfer. She underwent follow-up at two months, five months, and one year. Only two other cases of a delayed EPL rupture following a minimally displaced distal radius fracture in a skeletally immature patient managed non-operatively have been reported. This case illustrates a successful outcome in a pediatric patient managed with an EIP tendon transfer.