title: The role of post-operative radiographs in predicting risk of flexor pollicis longus tendon rupture after volar plate fixation of distal radius fractures - a case control study.
abstract: OBJECTIVE
  Volar plating of distal radius fractures is one of the common procedures performed in trauma surgery. Flexor pollicis longus (FPL) rupture has been described as complication following volar plating of distal radius fractures. The aim of our study was to investigate the possible relation between parameters measured on post-operative radiographs and the occurrence of FPL ruptures.
  
  
  METHODS
  This was a case control study. The post-operative radiographs of 11 FPL rupture, and 22 non-FPL rupture patients were reviewed with respect to fracture reduction and plate position and the various parameters were calculated by five independent people. Logistic regression was used to examine the importance of the variables.
  
  
  RESULTS
  We identified two significant factors to predict FPL rupture after volar plating of distal radial fractures. These were radial tilt and plate distance from the joint line. The odds ratio of ruptures was 0.74 (95% CI 0.57-0.95) for every degree of radial tilt <25° and 0.50 (95% CI 0.28-0.88) for every millimetre that the distal end of the plate was away from the volar lip of the distal radius at the wrist joint.
  
  
  CONCLUSIONS
  Post-operative radiographs could help us predict FPL rupture after distal radius volar plating. The findings also highlight the need for good fracture reduction and thoughtful placement of the volar plate intraoperatively to minimise the risk of FPL tendon rupture.
authors.affiliation: Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK. Electronic address: daveselvan@doctors.org.uk.
authors.forename: D R
authors.initials: DR
authors.lastname: Selvan
authors.affiliation: Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK.
authors.forename: D
authors.initials: D
authors.lastname: Perry
authors.affiliation: Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK.
authors.forename: D G
authors.initials: DG
authors.lastname: Machin
authors.affiliation: Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Brown
mesh_terms: D016022:Case-Control Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D017102:Fracture Healing; D006801:Humans; D053401:Palmar Plate / Q000000981:diagnostic imaging* / Q000293:injuries / Q000601:surgery; D011184:Postoperative Period; D011859:Radiography; D011885:Radius Fractures / Q000000981:diagnostic imaging* / Q000601:surgery; D012421:Rupture / Q000000981:diagnostic imaging* / Q000209:etiology; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome
keywords: Distal radius; Flexor pollicis longus; Fracture; Rupture; Tendon; Volar plating