title: A survey of extensor pollicis longus tendon injury at the time of distal radius fractures.
abstract: BACKGROUND
  The purpose of this study is to investigate the presence or absence, incidence, and degree of extensor pollicis longus (EPL) tendon injury by visual confirmation of the EPL at the time of osteosynthesis for distal radius fractures.
  
  
  METHODS
  The subjects were 25 patients (5 males and 20 females; mean age: 56 years) with distal radius fracture that had a dorsal roof fragment. During osteosynthesis using a volar locking plate, the third compartment was exposed in order to determine the EPL injury. The survey items in this study were: incidences of the forms of EPL injury (1: absent, 2: tendon floor fibrillation, and 3: laceration), and the presence or absence of periosteal rupture on the EPL tendon floor. In addition, on the final follow-up, the presence or absence of EPL rupture, the range of wrist motion, grip strength, Visual Analog Scale (VAS) score, Quick Disabilities of the Arm, Shoulder and Hand (Q-DASH) score, and the Mayo wrist score were investigated.
  
  
  RESULTS
  During the operation, EPL injury was classified as: 1) absent (12%), 2) tendon floor fibrillation (52%), or 3) laceration (36%). In the EPL tendon floor, periosteal rupture was observed in all patients. The mean postoperative follow-up period was 8 months (6-12 months) and no EPL rupture was observed in any patient. The wrist range of motion was 71° for flexion, 75° for extension, 84° for pronation, and 85° for supination, and the grip (% compared with the unaffected side) was 79%. The VAS, Q-DASH and Mayo scores were 1, 10 and 93 respectively.
  
  
  CONCLUSIONS
  This study showed a high incidence of EPL tendon injury at the time of distal radius fractures (88%). To improve the ambient environment of the damaged tendon may be useful in terms of the prevention of tendon injury.
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan. Electronic address: knaito@juntendo.ac.jp.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Naito
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Sugiyama
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan; Department of Orthopaedics, Srinakharinwirot University, Nakhon Nayok, Thailand.
authors.forename: Thitinut
authors.initials: T
authors.lastname: Dilokhuttakarn
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Kinoshita
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Goto
authors.affiliation: Department of Orthopaedic Surgery, Juntendo University Nerima Hospital, Tokyo, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Aritomi
authors.affiliation: Department of Orthopaedic Surgery, Juntendo Tokyo Koto Geriatric Medical Center, Tokyo, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Iwase
authors.affiliation: Department of Orthopaedics, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates / Q000009:adverse effects*; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000503:physiopathology* / Q000601:surgery; D011885:Radius Fractures / Q000503:physiopathology / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture; D013708:Tendon Injuries / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome
keywords: Distal radius fracture; Dorsal roof fragment; Extensor pollicis longus injury; Third compartment