Delayed Rupture of the Extensor Pollicis Longus Tendon Following Intramedullary Nailing of Radial Shaft Fracture

Jin Yeong Park; Soon Ho Huh; Bo Hyun Jung

doi:10.4055/jkoa.2017.52.4.364

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Park, Huh, and Jung: Delayed Rupture of the Extensor Pollicis Longus Tendon Following Intramedullary Nailing of Radial Shaft Fracture

Original Article

J Korean Orthop Assoc 2017;52(4):364-369.

Published online: 1 December 2017

DOI: https://doi.org/10.4055/jkoa.2017.52.4.364

Delayed Rupture of the Extensor Pollicis Longus Tendon Following Intramedullary Nailing of Radial Shaft Fracture

Jin Yeong Park, M.D., Soon Ho Huh, M.D., Bo Hyun Jung, M.D.

Department of Orthopaedic Surgery, St. Carollo Hospital, Suncheon, Korea

Correspondence to: Soon Ho Huh, M.D. Department of Orthopaedic Surgery, St. Carollo Hospital, 221 Sungwang-ro, Suncheon 57931, Korea TEL: +82-61-720-2404 FAX: +82-61-720-2484 E-mail: Lacteaa@naver.com

Received 22 August 2016 Revised 23 September 2016 Accepted 5 October 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Delayed rupture of the extensor pollicis longus tendon mostly occur after plate fixation of distal radius fracture. However, delayed rupture of the extensor pollcis longus tendon following intramedullary nailing of radial shaft fracture is very rare. We report one case of delayed rupture of the extensor pollicis longus tendon following intramedullary nailing, presenting abnormal signs from adhesion of the extensor pollicis longus with extensor indicis at the nail insertion site.

Keywords: tendon injuries, tendon transfer, radius fractures

REFERENCES

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Figure 1

(A) Preoperative radiographs show radius shaft fracture. (B) Postoperative radiographs show the fracture treated with closed reduction and internal fixation using interlocking nail.

Figure 2

Ultrasonography showed loss of continuity of the extensor pollicis longus (arrow).

Figure 3

(A) Appearance of the distal ends of the ruptured extensor pollicis longus tendon. (B) Harvest of the extensor indicis tendon on metacarpophalangeal joint dorsal aspect. (C) The tendon transfer is done with the extensor indicis tendon.

Figure 4

(A) Abnormal signs included inability to extend the thumb when the second finger was in flexion. (B) But the thumb was able to be extended when the 2nd finger was in extension.

Figure 5

We performed adhesiolysis on the site of tendon transfer and interlocking nail insertion site.

Figure 6

Last follow-up. Note: full extension and dorsal elevation of thumb without extension of the 2nd finger.

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