Physeal Distal Radial Fracture with Entrapment of the Tendons of Extensor Pollicis Longus and Extensor Digitorum Communis to Index Finger

Abstract

We report the entrapment of the extensor tendons following a growth plate fracture of the distal radius in a teenager. It is difficult to detect tendon entrapment at the fracture site immediately after the injury and diagnosis is typically made after fracture union when patients present with an inability to extend the thumb/reduced digital movement. A careful examination of our patient demonstrated some loss of digital motion and the plain radiographs, and computed tomographic scan showed incomplete reduction suggesting tendon entrapment. Early detection of the entrapped tendons allowed prompt release averting the need for tendon reconstruction. This report highlights the need for clinicians to maintain a high index of suspicion for tendon entrapment in patients with distal radius fractures that present with limited digital motion associated with incomplete reduction. An early diagnosis followed by the timely release can result in excellent outcomes. Level of Evidence: Level V (Therapeutic)

Pragmatic use of ultrasound in plaster room

“…Soft tissue entrapment, as extensor tendons in wrist fracture, prevent any attempt to fracture reduction, 12,13 ultrasound could potentially detect entrapment and explain a failure of reduction.…”