Extensor pollicis longus ruptures in distal radius fractures: clinical and cadaveric studies with a new therapeutic intervention.

We conducted a study to evaluate aspiration of the third dorsal compartment as a therapeutic option for preventing extensor pollicis longus ruptures in association with distal radius fractures. A cadaveric model with a nondisplaced distal radius fracture was created, and radiopaque (Hypaque) dye was injected into the fracture site. Pressure readings were taken from the third dorsal compartment before and after dye injection. The compartment was aspirated with an 18-gauge needle, and compartment pressures were measured again. There was a significant decrease in pressures after aspiration. Results in our cadaveric model were consistent with those in in vitro decompression of the third dorsal compartment. Clinical studies may determine that in-office needle aspiration is beneficial in preventing extensor pollicis longus rupture in nondisplaced distal radius fractures.