Ventura Jenny Stephanie, Manzanarez Felix Karlos, Lackey Joshua Taylor, Leis Amber Rachel
University of California, Irvine School of Medicine, Irvine, CA.
Department of Orthopedic Surgery, University of California, Irvine, CA.
J Hand Surg Glob Online. 2024 Jul 15;6(5):670-673. doi: 10.1016/j.jhsg.2024.06.007. eCollection 2024 Sep.
Tendon entrapment is a rare complication of closed forearm fractures. A 16-year-old boy sustained a type 1 open both bone forearm fracture after falling from a skateboard. The injury was initially managed with irrigation, debridement, and flexible intramedullary nailing. Seven weeks after surgery, a flexion contracture of the ipsilateral thumb interphalangeal joint was noted. Subsequent hardware removal and hand therapy failed to improve thumb extension. The patient was taken to the operating room for planned tenolysis and possible tendon reconstruction. Intraoperatively, the flexor pollicis longus tendon was found to be wrapped around the radial shaft as an apparent complication of the initial procedure, which necessitated division and reconstruction of the tendon. To our knowledge, this is the first pediatric reported case of dorsal flexor pollicis longus tendon entrapment through the fracture site in a both bone forearm fracture requiring tendon reconstruction. This case highlights a unique surgical approach to a novel complication of pediatric both bone forearm fracture.
肌腱卡压是闭合性前臂骨折的一种罕见并发症。一名16岁男孩从滑板上摔下后发生了1型开放性双骨折前臂骨折。该损伤最初通过冲洗、清创和弹性髓内钉固定进行处理。术后7周，发现同侧拇指指间关节出现屈曲挛缩。随后取出内固定物并进行手部治疗，但拇指伸展功能未能改善。患者被送往手术室进行计划中的肌腱松解术及可能的肌腱重建。术中发现拇长屈肌腱缠绕在桡骨干上，这显然是初始手术的并发症，因此需要对肌腱进行切断和重建。据我们所知，这是第一例报道的小儿双骨折前臂骨折中拇长屈肌腱通过骨折部位发生背侧卡压并需要进行肌腱重建的病例。该病例突出了针对小儿双骨折前臂骨折一种新并发症的独特手术方法。
