Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child - A Case Report -

Seung-Ju Jeon; Haeng-Kee Noh; Do-Yeon Kim; Sung-Hoon Jung; Jun-Beum Shin; Ho-Seung Jeon

doi:10.12671/jkfs.2013.26.1.65

Journal List > J Korean Fract Soc > v.26(1) > 1037962

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Jeon, Noh, Kim, Jung, Shin, and Jeon: Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child - A Case Report -

Case Report

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2013; 26(1): 65-68.

Published online: 17 January 2013

DOI: https://doi.org/10.12671/jkfs.2013.26.1.65

Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child - A Case Report -

Seung-Ju Jeon, M.D., Haeng-Kee Noh, M.D., Do-Yeon Kim, M.D., Sung-Hoon Jung, M.D.^*, Jun-Beum Shin, M.D.^*, Ho-Seung Jeon, M.D.

Department of Orthopaedic Surgery, Sung-Ae Hospital, Seoul, Korea.

^*Department of Orthopaedic Surgery, Gwangmyeong Sung-Ae Hospital, Gwangmyeong, Korea.

Address reprint requests to: Ho-Seung Jeon, M.D. Department of Othopaedic Surgery, Sung-Ae Hospital, 22, Yeouidaebang-ro 53-gil, Yeongdeungpo-gu, Seoul 150-960, Korea. Tel: 82-2-532-9554, Fax: 82-2-840-7755, hsjeonos@naver.com

Received 21 June 2012 Revised 29 August 2012 Accepted 2 November 2012

(open-access):

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

Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.

Keywords: Extensor pollicis longus tendon, Smith's fracture, Entrapment of EPL tendon, Open reduction

Figures and Tables

Fig. 1

(A) Initial radiograph of the right wrist shows severe displacement of distal fracture fragment toward the volar side in Smith's fracture.

(B) Radiographs after reduction.

Fig. 2

Preoperative computed tomography scan of the right wrist shows persistent gap at the fracture site after reduction.

Fig. 3

The distal portion of extensor pollicis longus (EPL) tendon is found, but proximal portion is not seen (red arrow). EPL goes through a gap of fracture site and towards the dorsal side of the fracture site where it used to go through the proximal facture site.

Fig. 4

The intraoperative photographs after reduction of the extensor pollicis longus (EPL) tendon (blue arrow). Fractured cortical bone fragment was reduced (red arrow). Entrapted EPL tendon was reduced from volar side to dorsal side.

Fig. 5

(A, B) Open reduction and internal fixation with Kirschner wires was done.

References

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