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Review Question - QID 669

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QID 669 (Type "669" in App Search)
Twelve months after open reduction and internal fixation of a comminuted distal radius fracture as seen in Figure A and B, which of the following tendons is at greatest risk of rupture?
  • A
  • B

Abductor Pollicis Longus

5%

100/2127

Extensor Pollicis Brevis

7%

159/2127

Extensor Indicis Proprius

13%

271/2127

Flexor Pollicis Brevis

1%

25/2127

Flexor Pollicis Longus

73%

1556/2127

  • A
  • B

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Figure A shows a distal radius fracture treated with a volar locked plate. Historically, distal radius fractures treated with dorsal plates were notorious for extensor tendon irritation with some cited rates as high as 50%.

In the reference by Drobetz et al, they reviewed 50 fractures treated with a volar locked plate. They noted that in 6 (12%) of cases that there was rupture of the flexor pollicis longus (FPL) at a mean of 10 months post operatively.

The second reference by Douthit is a retrospective review of 46 fractures treated with a volar locked plate. Excellent initial and maintenance of reduction was noted in 85% of cases, but FPL rupture occurred in 2 patients. Prominent plates and sharp screws were cited as reasons for tendon rupture.

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