Flexor pollicis longus tendon rupture by sandwiched underlying volar locking plate and distal radius
Flexor pollicis longus tendon rupture by sandwiched underlying volar locking plate and distal radius
复制标题
夹在下面的掌侧锁定板和远端桡骨导致拇长屈肌腱断裂
DOI：
10.1007/s10396-018-0882-1
复制
发表时间：
2018
影响因子：
1.8
通讯作者：
Nakamura Hiroaki
中科院分区：
文献类型：
--
作者：
Uemura Takuya;Okano Tadashi;Onode Ema;Yokoi Takuya;Shintani Kosuke;Okada Mitsuhiro;Nakamura Hiroaki
拇长屈肌腱断裂是掌侧锁定钢板治疗桡骨远端骨折的主要并发症。肌腱断裂通常是由钢板远端边缘与FPL肌腱之间的摩擦引起的，最近超声检查已被很好地检测到。掌侧锁定钢板本身很少会卡住FPL肌腱，导致其断裂。一名63岁的男子在另一家医院接受桡骨远端骨折手术后一直无法弯曲右手拇指。超音波检查显示肌腱滑动丧失及FPL肌腱异常型态。肌腱夹在钢板和桡骨远端之间，并被远端锁定螺钉穿透，这与术中发现的FPL肌腱从下方钢板完全卡压和断裂相当。取出螺钉和钢板后，使用掌长肌腱移植修复肌腱缺损。他终于可以满意地活动拇指了。如本例，必须认识到钢板定位不当导致FPL肌腱断裂的不寻常模式。超声检查是桡骨远端骨折掌侧锁定钢板固定后常规推荐的检查方法，以明确FPL肌腱损伤情况。
Flexor pollicis longus (FPL) tendon rupture is a major complication of volar locking plate fixation for distal radius fractures. The tendon rupture is usually caused by friction between the distal edge of the plate and the FPL tendon, and has been well detected recently with ultrasonography. Rarely, the volar locking plate itself entraps the FPL tendon, leading to its rupture. A 63-year-old man was consistently unable to flex his right thumb after previous surgery for a distal radius fracture at another hospital. Ultrasonography demonstrated loss of tendon gliding and unusual patterns of the FPL tendon. The tendon was sandwiched between the plate and the distal radius, and was penetrated by the distal locking screw, which was comparable to intraoperative findings of complete entrapment and rupture of the FPL tendon from the underlying plate. The tendon defects were repaired using a palmaris longus tendon graft after removing the screws and plate. Finally, he could flex his thumb actively with satisfaction. Unusual patterns of FPL tendon rupture buried under inadequate plate positioning must be recognized, as in this case. Ultrasonographic assessment is routinely recommended to visibly determine any FPL tendon damage after volar locking plate fixation for distal radius fractures.