J Korean Fract Soc.  2017 Apr;30(2):63-68. 10.12671/jkfs.2017.30.2.63.

Radiologic Analysis of Distal Radius Fracture Accompanying Spontaneous Extensor Pollicis Longus Rupture

• Lee JK
• Hong IT
• Kwon YW
• Jang GC
• Han SH

• KMID: 2376611
• DOI: http://doi.org/10.12671/jkfs.2017.30.2.63

Abstract

PURPOSE
The spontaneous extensor pollicis longus (EPL) tendon rupture is a well-documented complication of non-displaced or minimally displaced distal radius fracture. Authors analyzed the radiographs of patients treated for closed EPL rupture after distal radius fracture.
MATERIALS AND METHODS
Twenty-eight patients (21 females, 7 males; average age of 58 years) with tendon transfer for spontaneous rupture of EPL after distal radius fracture were included. Wrist radiographs were taken at the first visit with EPL rupture. On the lateral view, posterior cortical displacement, distance from highest point in Lister's tubercle to fracture line, and height of the Lister's tubercle were measured. The distance from the lunate facet to the fracture line was measured on anteroposterior view. Radiologic change at the time of EPL rupture around the Lister's tubercle was evaluated by comparing it with the contra lateral wrist radiograph. Radial beak fracture pattern was also identified.
RESULTS
The interval between the injury and the spontaneous EPL rupture varied from 2 to 20 weeks, with an average of 6.7 weeks. There were 25 cases of non-displacement, 3 cases of mean 2.0 mm cortical displacement. The average distance from the lunate facet to the fracture line was 9.1 mm (3-12.1 mm), from the highest point in Lister's tubercle to the fracture line was 3.0 mm toward proximal radius (1.7-4.9 mm). The average height of the Lister's tubercle was 3.4 mm in the injured wrist and 3.1 mm in the opposite wrist. Radial beak fracture pattern was shown at 11 cases.
CONCLUSION
All cases presented no or minimal displaced fracture, and the fracture line was in the vicinity of the Lister's tubercle. Those kinds of fractures can highlight the possibility of spontaneous EPL rupture, depites its rarity.

Keyword

Distal radius fracture; Extensor pollicis longus; Rupture; Lister's tubercle; Radiologic analysis

MeSH Terms

Animals
Beak
Female
Humans
Male
Radius Fractures*
Radius*
Rupture*
Rupture, Spontaneous
Tendon Transfer
Tendons
Wrist

Figure

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  Fig. 1 Flow sheet depicts history (Hx) of study patients (pts).

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  Fig. 2 Distance to Fracture line is measured from lunate facet to fracture line.

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  Fig. 3 Height of the Lister's tubercle is measured from the dorsal aspect of the radial metaphysis to the highest point in the Lister's tubercle.

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  Fig. 4 Distance from Lister's tubercle to the fracture line is measured from the highest point in Lister's tubercle to the fracture line.

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  Fig. 5 Radial beak fracture pattern shows that the fracture line deviates from transverse to proximal at the radial side.

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