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桡骨远端骨折后第一伸肌间隔卡压：病例报告

First Extensor Compartment Entrapment After Distal Radius Fracture: Case Report.

作者信息

Jou Christopher, Bahat Daniel, Chepla Kyle J

机构信息

Plastic Surgery, Cleveland Clinic, Cleveland, USA.

Plastic Surgery, MetroHealth Medical Center, Cleveland, USA.

出版信息

Cureus. 2024 Nov 6;16(11):e73125. doi: 10.7759/cureus.73125. eCollection 2024 Nov.

DOI:10.7759/cureus.73125
PMID:39650986
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11624320/
Abstract

We report a unique case of first extensor compartment tendon entrapment (abductor pollicis longus [APL] and extensor pollicis brevis [EPB]) after a volarly displaced Salter-Harris type II distal radius fracture in a 16-year-old male. After unsuccessful treatment with closed reduction and pinning, open reduction was performed, which revealed the entrapment of the APL and EPB tendons within the fracture, requiring surgical dis-impaction, freeing of tendons, and stabilization with volar locking plate fixation. Post-operatively, there was no loss of reduction and the patient demonstrated full, pain-free thumb range of motion at follow-up. Extensor tendon entrapment typically presents with loss of motion or unsuccessful closed reduction. The extensor pollicis longus (EPL) tendon was most commonly involved and there were no prior reports of APL or EPB entrapment. Our case highlights the importance of considering tendon entrapment after a volar-displaced distal radius fractures, particularly when closed reduction is unsuccessful and recommend prompt surgical exploration in this setting.

摘要

我们报告了一例独特的病例，一名16岁男性在桡骨远端Salter-Harris II型骨折掌侧移位后出现第一伸肌间隔肌腱卡压（拇长展肌[APL]和拇短伸肌[EPB]）。在闭合复位和穿针治疗失败后，进行了切开复位，发现APL和EPB肌腱在骨折处被卡压，需要手术解除嵌压、松解肌腱，并使用掌侧锁定钢板固定进行稳定。术后，骨折无移位丢失，患者在随访时拇指活动范围完全且无痛。伸肌腱卡压通常表现为活动丧失或闭合复位失败。拇长伸肌（EPL）肌腱最常受累，此前尚无APL或EPB卡压的报道。我们的病例强调了在桡骨远端掌侧移位骨折后考虑肌腱卡压的重要性，特别是在闭合复位失败时，并建议在这种情况下及时进行手术探查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/097d25ffc5fe/cureus-0016-00000073125-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/74c483df2524/cureus-0016-00000073125-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/f29370571231/cureus-0016-00000073125-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/c6ea996a3393/cureus-0016-00000073125-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/78ce8f72d98f/cureus-0016-00000073125-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/ba88be4d505d/cureus-0016-00000073125-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/097d25ffc5fe/cureus-0016-00000073125-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/74c483df2524/cureus-0016-00000073125-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/f29370571231/cureus-0016-00000073125-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/c6ea996a3393/cureus-0016-00000073125-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/78ce8f72d98f/cureus-0016-00000073125-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/ba88be4d505d/cureus-0016-00000073125-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91bf/11624320/097d25ffc5fe/cureus-0016-00000073125-i06.jpg

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本文引用的文献

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Radial Wrist Extensor Tendon Entrapment in Volarly Displaced Distal Radius Fracture: A Report of 2 Cases.桡骨远端骨折伴掌侧半脱位时的腕伸肌腱卡压：2 例报告。
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Extensor Tendon Entrapment on Computed Tomography Imaging of Distal Radius Fractures.
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