Williams James, Wharton Rupert, Peev Peter, Horwitz Maxim
Department of Trauma and Orthopaedic Surgery, Ealing Hospital, London North-West Healthcare, United Kingdom.
Department of Trauma and Orthopaedic Surgery, St Mary's Hospital, Imperial College Healthcare, United Kingdom.
Trauma Case Rep. 2018 Apr 26;15:1-3. doi: 10.1016/j.tcr.2018.04.001. eCollection 2018 Jun.
Delayed rupture of the extensor and flexor tendons are recognised complications of distal radius fractures. However, acute flexor tendon rupture in the context of forearm fractures is rare. A twelve-year-old female sustained midshaft fractures of the radius and ulna. Intra-operatively the flexor pollicis longus (FPL) was found to be stripped from its musculotendinous junction at the level of the fracture fragment. The ruptured tendon was repaired using a modified Krackow technique at the time of fracture fixation. The repair was protected in plaster of Paris prior to referral to the paediatric hand clinic. The patient made a full recovery. Flexor tendon injury is a rare but potentially devastating consequence of acute forearm fractures. High energy trauma, significant volar angulation of the fracture fragment and clinical signs of flexor tendon injury should raise suspicion of this injury. A high index of suspicion in conjunction with repeat clinical examination of flexor tendon function should be performed before opting for closed management or intramedullary nailing in paediatric patients.
伸肌腱和屈肌腱延迟断裂是桡骨远端骨折公认的并发症。然而，在前臂骨折的情况下急性屈肌腱断裂较为罕见。一名12岁女性桡骨和尺骨中轴骨折。术中发现拇长屈肌（FPL）在骨折碎片水平处从其肌腱结合部剥离。在骨折固定时，采用改良的Krackow技术修复断裂的肌腱。在转诊至小儿手外科门诊之前，用巴黎石膏对修复处进行保护。患者完全康复。屈肌腱损伤是急性前臂骨折罕见但可能具有毁灭性的后果。高能量创伤、骨折碎片明显的掌侧成角以及屈肌腱损伤的临床体征应引起对此损伤的怀疑。在小儿患者选择闭合治疗或髓内钉固定之前，应高度怀疑并反复临床检查屈肌腱功能。
