As volar plate fixation of distal radius fracture becomes more common, reports of ruptured extensor pollicis longus tendon by a protruding distal screw tip are also increasing steadily. Authors have experienced a rare case of ruptured extensor pollicis longus tendon at the prominent proximal screw of fixed volar plate for distal radius fracture, and we report it herein with a review of the literature.
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.
As a complication of Smiths fracture, traumatic entrapment and closed rupture of the extensor pollicis longus tendon may occur rarely at the fracture site and cause loss of thumb extenion. Traumatic entrapment of the extensor pollicis longus tendon in Smiths fracture which was anatomic barrier of successful closed reduction was first described by Hunt in 1969. Since then, several authors reported another few cases.
The mechanism of tendon rupture in Smiths fracture is thought that the sharp dorsal edge of the proximal fragment may tear the stretched muscular tendon unit during extreme wrist flexion.
We experienced a case of traumatic rupture of the extensor pollicis longus tendon associated with a closed Smiths fracture and report this case with our treatment method.