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Review Question - QID 288

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QID 288 (Type "288" in App Search)
Spontaneous rupture of the extensor pollicis longus tendon is most frequently associated with which of the following scenarios?

Non-displaced distal radius fracture

84%

1048/1245

Non-displaced Rolando fracture

5%

58/1245

Second metacarpal base fracture

4%

51/1245

Boxer's fracture

1%

16/1245

Non-displaced radial styloid fracture

5%

62/1245

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Rupture of the extensor pollicis longus (EPL) tendon after non operative treatment for a distal radius fracture occurs with a 0.3-5% incidence. The causes of EPL rupture include mechanical irritation, attrition, and vascular impairment leading to delayed rupture. Synovitis of the extensor carpi radialis due to repetitive use may invade the EPL tendon and lead to rupture. Recommended treatment in the pre-rupture setting includes a third dorsal compartment release with or without an extensor retinacular patch graft. Palmaris longus graft or a transfer from the extensor indicis proprius to the EPL tendon are reasonable treatment options. Results of all treatments seem to be clinically satisfactory.

The referenced article by Gelb is a review of the etiology and treatment of this injury. He reviews the above discussion and findings.

REFERENCES (1)
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