Extensor Pollicis Longus Tendon Ruptures After the Use of Volar Locking Plates for Distal Radius Fractures

Zenke, Yukichi; Sakai, Akinori; Oshige, Toshihisa; Moritani, Shiro; Menuki, Kunitaka; Yamanaka, Yoshiaki; Furukawa, Kayoko; Nakamura, Toshio

doi:10.1142/s0218810413500196

Cited by 32 publications

(21 citation statements)

References 12 publications

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“…Using the preoperative planning, it was easy to determine the screw sizes even when there were comminuted fragments at the dorsal cortex of the radius. The length of distal locking screws is important because it relates with the fixation strength and extensor complications …”

Section: Discussionmentioning

confidence: 99%

“…The length of distal locking screws is important because it relates with the fixation strength and extensor complications. 23 It has been suggested that locked unicortical distal screws of at least 75% of the length of bicortical screws offer construct stiffness similar to bicortical fixation. 24 At the same time, there is a risk of penetration to the extensor compartment when choosing longer screws.…”

Section: D Planning For the Distal Radius Fracturementioning

confidence: 99%

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Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures

Yoshii

Kusakabe

Akita³

et al. 2017

Journal Orthopaedic Research

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A three-dimensional (3D) digital preoperative planning system for the osteosynthesis of distal radius fractures was developed for clinical practice. To assess the usefulness of the 3D planning for osteosynthesis, we evaluated the reproducibility of the reduction shapes and selected implants in the patients with distal radius fractures. Twenty wrists of 20 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The 3D preoperative planning was performed prior to each surgery. Four surgeons conducted the surgeries. The surgeons performed the reduction and the placement of the plate while comparing images between the preoperative plan and fluoroscopy. Preoperative planning and postoperative reductions were compared by measuring volar tilt and radial inclination of the 3D images. Intra-class correlation coefficients (ICCs) of the volar tilt and radial inclination were evaluated. For the implant choices, the ICCs for the screw lengths between the preoperative plan and the actual choices were evaluated. The ICCs were 0.644 (p < 0.01) and 0.625 (p < 0.01) for the volar tilt and radial inclination in the 3D measurements, respectively. The planned size of plate was used in all of the patients. The ICC for the screw length between preoperative planning and actual choice was 0.860 (p < 0.01). Good reproducibility for the reduction shape and excellent reproducibility for the implant choices were achieved using 3D preoperative planning for distal radius fracture. Three-dimensional digital planning was useful to visualize the reduction process and choose a proper implant for distal radius fractures. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2646-2651, 2017.

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Section: Discussionmentioning

confidence: 99%

Section: D Planning For the Distal Radius Fracturementioning

confidence: 99%

Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures

Yoshii

Kusakabe

Akita³

et al. 2017

Journal Orthopaedic Research

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“…[4][5][6] Notwithstanding this potential advantage, various reports of extensor tendon ruptures after volar plating of DRFs have been described and are believed to be the result of prominent screws extending through the dorsal cortex. [10][11][12][13][14][15] Propagated by these complications, several fluoroscopic views have been introduced to assist surgeons and improve the confidence that the distal screws are not prominent on the dorsal cortex.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Dorsal plates have fallen out of favor due to extensor tendon irritation and rupture. [4][5][6] The inception of volar-locked plates offered stable fixation without violation of the dorsal soft tissues. However, several studies have reported complications of extensor tendon ruptures after the application of volar plating of distal radius fractures.…”

Section: Introductionmentioning

confidence: 99%

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures

Hill

Shakir

Cannada

2015

Journal of Orthopaedic Trauma

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“…(33) However, the incidence of this injury has been shown to be substantial following volar plate fixation of distal radius fractures, with reported rates ranging from 0-4%. (34)(35)(36)(37)(38)(39) While multiple extensor tendons are at risk, including the extensor digitorum communis and extensor indicis,(40) the extensor pollicis longus (EPL) tendon is the most frequently affected. Zenke et al (34) reported EPL rupture in 2% of a cohort of 286 patients treated with volar plating, while Tarallo et al (35) reported EPL rupture rate of 1% in a cohort of 303 patients.…”

Section: Tendon Injurymentioning

confidence: 99%

Complications Associated with Volar Locking Plate Fixation of Distal Radial Fractures

Alter

Ilyas²

2018

JBJS Rev

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Distal radius fractures are among the most common orthopaedic injuries. Of 590,193 fractures of the upper extremity documented in the United States in 2009, distal radius fractures were the most common.(1) Additionally, they comprise one-sixth of all fractures seen in the emergency room.(2) In recent years, incidence of this already common fracture has continued to increase in pediatric, adult, and elderly populations alike.(3) However, despite the high incidence of distal radius fractures, consensus regarding optimal treatment strategy still does not exist. Current treatment options include closed reduction, closed reduction with percutaneous pinning, intramedullary fixation, external fixation, and various open reduction and internal fixation strategies.(4, 5) Of these, open reduction and internal fixation with plates has seen a steady increase in use over the past two decades due to purported faster functional recovery and better radiographic alignment,(6) although better radiographic outcome does not necessarily translate to better long-term functional outcome in all groups.(7, 8) During this time there has been a simultaneous decreased use of dorsal plating due to concerns for extensor tendon irritation,(9) and a concomitant increase in the use of volar locked plating of distal radius fractures, particularly among newer surgeons.(10) Volar locked plating of distal radius fractures has grown in popularity for several reasons including a consistent and reproducible surgical approach, broad range of fractures patterns that a volar plate can treat, and a reasonable complication profile compared to other operative fixation methods with a reportedly lesser rate of tendon injury.(11) However, there remain fractures that should not be treated with volar plating, including highly comminuted fractures which may be better managed with wrist arthrodesis.(12, 13) Additionally, the exact incidence and pattern of complications from volar locking plates for distal radius fractures are not well understood. 3 EVOLUTION OF VOLAR LOCKING PLATE TECHNOLOGY Volar plating of distal radius fractures has been a surgical option since the introduction of AO principles of fracture fixation. Initially, volar plates were primarily indicated for buttress reduction and fixation of volar shear fractures, aka volar Barton's fractures.(14, 15) (FIGURE 1)

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Extensor Pollicis Longus Tendon Ruptures After the Use of Volar Locking Plates for Distal Radius Fractures

Cited by 32 publications

References 12 publications

Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures

Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures

Dorsal Screw Penetration With the Use of Volar Plating of Distal Radius Fractures

Complications Associated with Volar Locking Plate Fixation of Distal Radial Fractures

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