Spontaneous rupture of extensor pollicis longus after distal radius fracture: a case report

Authors

  • Miguel Jiménez-Yarza Department of General Surgery, Hospital Regional Monterrey-Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Monterrey, Mexico
  • Fernando Téllez-Pallares Department of Plastic Surgery, Centro Médico Nacional Siglo XXI-Instituto Mexicano del Seguro Social, Mexico City, Mexico
  • Francisco Alberto Olvera-Yarza Department of Plastic Surgery, Centro Médico Nacional Siglo XXI-Instituto Mexicano del Seguro Social, Mexico City, Mexico
  • José Gerardo Solano-Vázquez Department of Plastic Surgery, UMAE Hospital de Traumatología, Ortopedia y Rehabilitación “Dr Victorio de la Fuente Narváez”-Instituto Mexicano del Seguro Social, Mexico City, Mexico

DOI:

https://doi.org/10.18203/2320-6012.ijrms20241570

Keywords:

Fracture, Tendon, Transfer

Abstract

Extensor pollicis longus tendon rupture, rare and linked to trauma or arthritis, is prevalent post-distal radius fractures. Mechanisms include friction and vascular issues. Manifestations occur 4-8 weeks’ post-trauma. We present the case of A 31-year-old male, post-motorcycle accident surgery for distal radius fracture, faced extensor pollicis longus tendon rupture. A surgical intervention transposed the extensor indicis proprius tendon, restoring thumb function. Successful closure and splinting showed no movement limitations at the 12-week follow-up, prompting a rehabilitation referral. Distal radius fracture treatments, whether operative or non-operative, entail risks of extensor tendon complications, notably extensor pollicis longus. While direct suture repair is optimal, studies endorse effective restoration of thumb function through tendon grafts, particularly utilizing the extensor indicis proprius. Rupture of the extensor pollicis longus, while uncommon, often occurs with distal radius fractures. Extensor indicis proprius grafting is recommended for superior efficacy over alternatives, emphasizing the need for accurate and timely diagnosis.

References

Al-Omari AA, AR Altamimi A, ALQuran EA, Ahmad Saleh AA, Alyafawee QM, Audat MZ, et al. Spontaneous Rupture of Extensor Pollicis Longus Tendon: Clinical and Occupational Implications, Treatment Approaches and Prognostic Outcome in Non-Rheumatoid Arthritis Patients: A Retrospective Study. Open Access Rheumatol. 2020;12:47-54.

Kim CH. Spontaneous Rupture of the Extensor Pollicis Longus Tendon. Arch Plast Surg. 2012;39(6):680.

Song D, Evans R, Arneja JS. Delayed Extensor Pollicis Longus Tendon Rupture following Nondisplaced Distal Radius Fracture in a Child. HAND. 2013;8(2):242-4.

Helal B, Chen SC, Iwegbu G. Rupture of the Extensor Pollicis Longus Tendon in Undisplaced Colles’ Type of Fracture. Hand. 1982;14(1):41-7.

Lee JK, Bang JY, Choi YS, Kim TH, Yu WJ, Han SH. Extensor pollicis longus tendon rupture caused by a displaced dorsal “beak” fragment of Lister’s tubercle in distal radius fractures. Handchir Mikrochir Plast Chir. 2019;51(03):199-204.

Ishak A, Rajangam A, Khajuria A. The evidence-base for the management of flexor tendon injuries of the hand: Review. Ann Med Surg. 2019;48:1-6.

García-Galicia A, Rueda-Mojica JS, Sánchez-Durán MA, Barragán-Hervella RG, Montiel-Jarquín ÁJ, Gaytán-Fernández S. Evolución clínica de trabajadores con fractura de radio distal Fernández III. Tratamiento no complicado quirúrgico y no quirúrgico. Cirugia Cir. 2021;89(3):377-83.

Seigerman D, Lutsky K, Fletcher D, Katt B, Kwok M, Mazur D, et al. Complications in the Management of Distal Radius Fractures: How Do We Avoid them? Curr Rev Musculoskelet Med. 2019;12(2):204-12.

De Francesco F, Pugliese P, De Francesco M, Pangrazi PP, Riccio M. Brachioradialis Muscle Tendon Transposition in Extensor Pollicis Longus Reconstruction: Anatomical Study and a New Surgical Approach. Hand (N Y). 2022;17(4):780-8.

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Published

2024-05-31

How to Cite

Jiménez-Yarza, M., Téllez-Pallares, F., Olvera-Yarza, F. A., & Solano-Vázquez, J. G. (2024). Spontaneous rupture of extensor pollicis longus after distal radius fracture: a case report. International Journal of Research in Medical Sciences, 12(6), 2113–2116. https://doi.org/10.18203/2320-6012.ijrms20241570

Issue

Section

Case Reports