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Extensor pollicis longus rupture after distal radius fracture: Results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting

Extensor pollicis longus Ruptur nach distaler Radiusfraktur: Ergebnisse der Rekonstruktion durch Transposition der Extensor indicis Sehne und postoperativer dynamischer Schienenbehandlung

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Zusammenfassung

Die Läsion der Extensor pollicis longus Sehne ist eine der häufigsten Strecksehnenverletzungen nach einer distalen Radiusfraktur. In den Jahren 2003 –2005 haben wir bei 31 Patienten mit Funktionsausfall der EPL–Sehne eine Extensor indicis Plastik mit postoperativer dynamischer Schienenbehandlung durchgeführt. Bei 25 Patienten führte eine operativ versorgte distale Radiusfraktur (bei 23 Patienten Bohrdrahtosteosynthese, bei 2 Patienten Plattenosteosynthese) zur EPL-Ruptur. Bei 6 Patienten war eine konservativ behandelte distale Radiusfraktur ursächlich. Von unseren 25 nachuntersuchten Patienten wiesen 9 (36 %) ein sehr gutes und 15 (60 %) ein gutes Ergebnis im Geldmacher Score auf. Wir konnten in unserem Krankengut keine Rerupturen identifizieren. Bei Läsionen der Extensor pollicis-Sehne ist die Transposition der Extensor indicis-Sehne ein einfaches und komplikationsarmes Verfahren. Durch diese Ersatzplastik kann eine erhebliche Verbesserung der Extension am Daumen erzielt werden.

Summary

Injury of the extensor pollicis longus tendon is one of the commonest extensor tendon injuries after distal radius fracture. In 2003–2005 we performed extensor indicis transfer in 31 patients with loss of function of the EPL tendon and postoperative dynamic splinting. In 25 patients, a distal radius fracture managed surgically led to the EPL rupture (wire internal fixation in 23 patients, plate internal fixation in 2 patients). In 6 patients, the cause was a distal radius fracture treated conservatively. Out of our 25 followed-up patients, 9 (36%) had a very good and 15 (60%) a good result in the Geldmacher score. We did not identify any re-rupture. In injuries of the extensor pollicis tendon, transposition of the extensor indicis tendon is a simple and uncomplicated procedure. Considerable improvement of thumb extension can be achieved through this substitution repair.

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Authors and Affiliations

  1. General Hospital Tulln, Tulln, Austria

    Markus Figl, Michael Mayer, Stefan Lederer, Robert Bogner & Martin Leixnering

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  1. Markus Figl
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  2. Michael Mayer
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  3. Stefan Lederer
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  4. Robert Bogner
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  5. Martin Leixnering
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Correspondence to Markus Figl.

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Figl, M., Mayer, M., Lederer, S. et al. Extensor pollicis longus rupture after distal radius fracture: Results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting. Wien Klin Wochenschr 123, 485–487 (2011). https://doi.org/10.1007/s00508-011-0038-4

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