J Korean Fract Soc.  2013 Oct;26(4):338-342. 10.12671/jkfs.2013.26.4.338.

Rupture of the Extensor Pollicis Longus Tendon at the Proximal Screw of Volar Plate Fixation for Distal Radius Fracture: A Case Report

  • 1Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea. nso1020@naver.com


As volar plate fixation of distal radius fracture becomes more common, reports of ruptured extensor pollicis longus tendon by a protruding distal screw tip are also increasing steadily. Authors have experienced a rare case of ruptured extensor pollicis longus tendon at the prominent proximal screw of fixed volar plate for distal radius fracture, and we report it herein with a review of the literature.


Extensor pollicis longus tendon rupture; Distal radius fracture; Volar plate fixation; Proximal screw

MeSH Terms

Radius Fractures
Palmar Plate*


  • Fig. 1 Postoperative plain radiographs show that the proximal screw tips of fixed volar plate are protruded about 1-2 mm from the dorsal cortex of distal radius. The arrow marks the causative screw of ruptured extensor pollicis longus tendon.

  • Fig. 2 Computerized tomographs show that any distal screws of fixed volar plate do not penetrate the dorsal cortex of distal radius, but the proximal screws are definitely protruded through the dorsal cortex. The middle one (arrow) is the most prominent screw in comparison of simple radiographs, measuring about 2.8 mm.

  • Fig. 3 Preoperative ultrasonography shows protruding screw tips and discontinuity of extensor pollicis longus tendon at distal forearm region.

  • Fig. 4 Intraoperative photographs show a complete rupture of extensor pollicis longus tendon, where the ends are torn and fraying at prominent proximal screw tip, measuring about 2.5 mm.


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