Barrera Janos, Ryu Jessica, Yao Jeffrey
Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, California.
Department of Orthopaedic Surgery, Stanford University School of Medicine, Stanford, California.
J Wrist Surg. 2019 Jun;8(3):245-249. doi: 10.1055/s-0038-1675562. Epub 2018 Nov 5.
Distal radius fractures are a relatively common injury, and rupture of the extensor pollicis longus (EPL) has been known to occur in a small number of nondisplaced distal radius fractures. In contrast, bony incarceration of the EPL tendon is an exceedingly rare occurrence and warrants special attention. Here we present a case of bony incarceration of the EPL tendon following distal radius fracture that mimicked tendon rupture. Following EPL release, the patient had improved function and pain in the wrist. We identified three case reports of EPL tendon entrapment following distal radius fracture, and compared and contrasted the clinical features of tendon rupture versus bony entrapment. Our results suggest that both the type of fracture (displaced vs. nondisplaced) and the chronicity of symptoms may provide important diagnostic clues for the hand surgeon managing distal radius fracture patients presenting with EPL dysfunction.
桡骨远端骨折是一种相对常见的损伤，已知在少数无移位的桡骨远端骨折中会发生拇长伸肌（EPL）断裂。相比之下，EPL肌腱的骨质嵌顿极为罕见，值得特别关注。在此，我们报告一例桡骨远端骨折后EPL肌腱骨质嵌顿的病例，该病例曾被误诊为肌腱断裂。在松解EPL后，患者腕部功能改善，疼痛减轻。我们检索到3例桡骨远端骨折后EPL肌腱嵌顿的病例报告，并对肌腱断裂与骨质嵌顿的临床特征进行了比较和对比。我们的结果表明，骨折类型（移位型与无移位型）和症状的慢性程度可能为处理出现EPL功能障碍的桡骨远端骨折患者的手外科医生提供重要的诊断线索。
