Zenke Yukichi, Oshige Toshihisa, Menuki Kunitaka, Yamanaka Yoshiaki, Murai Teppei, Furukawa Kayoko, Sakai Akinori
Department of Orthopedic Surgery, University Hospital of Occupational and Environmental Health, Japan.
J UOEH. 2014 Dec 1;36(4):257-64. doi: 10.7888/juoeh.36.257.
We examined 6 cases of tendon injuries that accompanied distal radius fractures using volar locking plate between April 2006 and March 2012. Male: one case, female: five cases, average age 57.0 (3370) years old. The fracture type was A2 in one case, A3 in four cases, and C2 in one case by AO classification. The average period for operation waiting was 2.7 days. We analyzed the time of occurrence of tendon rupture (extensor pollicis longus (EPL)･flexor pollicis longus (FPL)), the existence or not of screw prominence and dorsal roof fragment, and the positioning of the plate setting. The tendon ruptures were EPL in four cases, and FPL in two cases. The average period of rupture occurrence was 86.8 (1182) days. In four EPL tendon ruptures we recognized one marked screw prominence (16.7%), and two dorsal roof fragments (50%), both showing widespread displacement. Moreover, we recognized the malposition of the plate setting in the two cases of FPL tendon rupture (100%). The incidence of tendon ruptures accompanying distal radius fractures using volar locking plates was not low at all, therefore we should more pay attention to the prevention of this occurrence.
2006年4月至2012年3月期间，我们对6例伴有桡骨远端骨折的肌腱损伤患者使用掌侧锁定钢板进行了检查。男性1例，女性5例，平均年龄57.0（33～70）岁。根据AO分类，骨折类型为A2型1例，A3型4例，C2型1例。平均手术等待时间为2.7天。我们分析了肌腱断裂（拇长伸肌（EPL）、拇长屈肌（FPL））的发生时间、螺钉突出和背侧骨块的有无以及钢板放置的位置。肌腱断裂中，EPL断裂4例，FPL断裂2例。断裂发生的平均时间为86.8（1～182）天。在4例EPL肌腱断裂中，我们发现1例明显的螺钉突出（16.7%），2例背侧骨块（50%），均显示广泛移位。此外，在2例FPL肌腱断裂（100%）中我们发现了钢板放置位置不当。使用掌侧锁定钢板治疗桡骨远端骨折时肌腱断裂的发生率并不低，因此我们应更加注意预防这种情况的发生。
