Ultrasonic Evaluation of the Flexor Pollicis Longus Tendon Following Volar Plate Fixation for Distal Radius Fractures

Kara, Adnan | Celik, Haluk | Bankaoglu, Mujdat | Oc, Yunus | Bulbul, Murat | Sugun, Tahir Sadik

Article | 2016 | JOURNAL OF HAND SURGERY-AMERICAN VOLUME41 ( 3 ) , pp.374 - 380

Purpose To evaluate with ultrasound the thickness of the flexor pollicis longus (FPL) tendon and its relationship to the volar locking plate after the fixation of distal radius fractures. Methods We evaluated 27 type C2 and C3 distal radius fractures with ultrasound to evaluate damage to the FPL tendon after volar plate fixation. The thickness of the FPL tendon and its distance to the volar plate in the involved wrists and to the volar rim in the contralateral uninjured wrist were measured on sonograms taken 12 months postoperatively. Measurements of the involved wrists were compared with those of the intact wrists. Results The mean . . . plate-tendon distance in the involved wrist was considerably shorter than the mean volar rim-tendon distance in the intact wrist, and the FPL tendon was considerably thicker in the involved wrist than in the intact wrist. Conclusions In distal radial fractures treated with volar locking plates, increases in the thickness of the FPL tendon and a consequent decrease in the distance between the tendon and the plate can be determined with ultrasonography. This finding is a warning that asymptomatic tenosynovitis may eventually cause tendon ruptures. (Copyright (C) 2016 by the American Society for Surgery of the Hand. All rights reserved. Daha fazlası Daha az

Flexor tendon complications in comminuted distal radius fractures treated with anatomic volar rim locking plates

Kara, Adnan | Celik, Haluk | Oc, Yunus | Uzun, Metin | Erdil, Mehmet | Tetik, Cihangir

Article | 2016 | ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA50 ( 6 ) , pp.665 - 669

Objective: Anatomic volar rim locking plates are designed with the aim of treating intraarticular distal radius fractures. When used to treat comminuted distal radius fractures, these plates can damage the flexor tendons. In this study, we sought to determine the radiological and functional results and rate of complications of these plates. Methods: We retrospectively reviewed the records of 36 patients (28 males, 8 females; mean age: 46.4 years) with AO/OTA Type C2-C3 distal radius fractures treated with anatomic volar rim distal radius plates between January 2011 and December 2014. Radial length, radial inclination and palmar tilt . . . were compared with the intact wrist. Results were evaluated with the Mayo wrist and Lidstrom scores. Complications were documented throughout the follow-up period of 23.8 (range: 12 to 48) months. Results: Postoperative measurements of the radial length, inclination and palmar tilt did not differ significantly. Mayo wrist and Lidstrom scores were good and excellent in 27 and 32 patients, respectively. Flexor tenosynovitis was symptomatic in 15 patients and asymptomatic (localized swelling only) in 21. Plates were removed from 15 patients due to symptomatic tenosynovitis and from six patients due to partial rupture of the flexor pollicis longus tendon. The flexor digitorum profundus tendon of the second finger was also partially ruptured in three patients. Conclusion: Anatomic volar rim locking plates provide satisfying radiological and functional results in treating AO/OTA Type C2-C3 comminuted distal radius fractures. However, if these plates interfere with the union of the fracture, they should be removed to avoid potential tendon problems caused by their placement in the rim region. (C) 2016 Publishing services by Elsevier B.V. on behalf of Turkish Association of Orthopaedics and Traumatology Daha fazlası Daha az

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