Department of Orthopaedic Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.
Clin Orthop Surg. 2012 Dec;4(4):325-8. doi: 10.4055/cios.2012.4.4.325. Epub 2012 Nov 16.
Although extensor tendon rupture often occurs after volar plating for a distal radius fracture, a flexor tendon rupture is extremely rare. Most reported instances of flexor tendon ruptures after volar plating have involved improper placement of the plate, increased prominence of the distal edge of the plate because of collapse of the fracture site, use of custom-made plates, current steroid use by the patient, or a history of tendon injury. We report a case of delayed rupture of the flexor pollicis longus tendon 40 months after volar plating with a 3.5-mm T-locking compression plate for which the distal edge was located at the transverse ridge level of the distal radius. If symptoms such as tendon irritation occur in this situation, surgeons should consider removing the plate as soon as possible after bony union is achieved.
虽然伸肌腱断裂在桡骨远端骨折掌侧钢板固定后经常发生,但屈肌腱断裂极为罕见。大多数报道的掌侧钢板固定后屈肌腱断裂的病例都与钢板放置不当、由于骨折部位塌陷导致钢板远端边缘突出、使用定制钢板、患者当前使用类固醇或肌腱损伤史有关。我们报告了一例桡骨远端横嵴水平 3.5mm T 型锁定加压钢板掌侧固定后 40 个月发生的迟发性拇长屈肌腱断裂。如果在此情况下出现肌腱激惹等症状,在骨性愈合后应尽快考虑取出钢板。