Bridge Plate Failure with Extensor Tendon Injury: A Case Report and Literature Review

Background Dorsal spanning plate fixation is an increasingly popular method of fixation for certain distal radius fractures. Published outcomes are encouraging, but complications are still reported. Methods We present a case report of a 26-year-old woman with spanning plate breakage and extensor pollicis longus (EPL) metallosis, fraying, and near-complete rupture. The patient's unsuccessful follow-up led to this complication. Metallosis and damage to the extensor indices (EI) and distal extensor carpi radialis longus (ECRL) were intraoperative obstacles for tendon transfer to restore EPL function. Results Tendon transfer in the setting of bridge plate failure has not yet been described in the literature. There are reports of spanning plate failure indicating that breakage often happens through the plate's holes and after fracture healing. Conclusions The compounded complication of plate failure with extensor tendon injury emphasizes the important relationship between the local anatomy, barriers to patient care, and potential problems after spanning plate fixation.

[1]  R. Sarpong,et al.  Bio-inspired synthesis of xishacorenes A, B, and C, and a new congener from fuscol† †Electronic supplementary information (ESI) available. See DOI: 10.1039/c9sc02572c , 2019, Chemical science.

[2]  M. Stevanovic,et al.  A Biomechanical Comparison of Distal Fixation for Bridge Plating in a Distal Radius Fracture Model. , 2017, The Journal of hand surgery.

[3]  Y. Sugiyama,et al.  A survey of extensor pollicis longus tendon injury at the time of distal radius fractures. , 2017, Injury.

[4]  J. Lubahn,et al.  Hand Surgeon Reporting of Tendon Rupture Following Distal Radius Volar Plating , 2016, Hand.

[5]  J. Elfar,et al.  Anatomic relationships in distal radius bridge plating: a cadaveric study , 2015, Hand.

[6]  M. Stevanovic,et al.  Risk of tendon entrapment under a dorsal bridge plate in a distal radius fracture model. , 2015, The Journal of hand surgery.

[7]  Chih-hung Lin,et al.  Revisiting spontaneous rupture of the extensor pollicis longus tendon: eight cases without identifiable predisposing factor , 2015, Hand.

[8]  F. Catani,et al.  Volar Plate Fixation for the Treatment of Distal Radius Fractures: Analysis of Adverse Events , 2013, Journal of orthopaedic trauma.

[9]  P. Blazar,et al.  Incidence of extensor pollicis longus tendon rupture after nondisplaced distal radius fractures. , 2012, The Journal of hand surgery.

[10]  D. Ruch,et al.  Distraction plating for the treatment of highly comminuted distal radius fractures in elderly patients. , 2012, The Journal of hand surgery.

[11]  W. Marsden.  I and J , 2012 .

[12]  P. Blazar,et al.  Volar locking plate implant prominence and flexor tendon rupture. , 2011, The Journal of bone and joint surgery. American volume.

[13]  S. Trigg.  Volar Locking Plate Implant Prominence and Flexor Tendon Rupture , 2011 .

[14]  D. Brown,et al.  Minimising the risk of extensor pollicis longus rupture following volar plate fixation of distal radius fractures: a cadaveric study. , 2011, Annals of the Royal College of Surgeons of England.

[15]  D. Hanel,et al.  Complications associated with distraction plate fixation of wrist fractures. , 2010, Hand clinics.

[16]  A. Suckel,et al.  Dorsal (AO/ASIF) Pi-Plate Osteosynthesis in the Treatment of Distal Intraarticular Radius Fractures , 2006, Journal of hand surgery.

[17]  D. Hanel,et al.  Bridge Plating of Distal Radius Fractures: The Harborview Method , 2006, Clinical orthopaedics and related research.

[18]  D. Ruch,et al.  Use of a distraction plate for distal radial fractures with metaphyseal and diaphyseal comminution. , 2005, The Journal of bone and joint surgery. American volume.