Case Reports
Delayed Rupture of the Flexor Pollicis Longus Tendon After Routine Volar Placement of a T-Plate on the Distal Radius
Am J Orthop. 2007 December;36(12):669-670
Author and Disclosure Information
Scott F. M. Duncan, MD, and Andrew J. Weiland, MD
Dr. Duncan is Assistant Professor of Orthopaedic Surgery, Mayo Clinic, Scottsdale, Arizona. He was Senior Clinical Associate in Orthopaedic Surgery, Weill Medical College of Cornell University, New York, New York, at the time the article was written.
Dr. Weiland is Professor of Orthopaedic Surgery, Department of Orthopedics, Hospital for Special Surgery, New York, New York.
Abstract not available. Introduction provided instead.
The standard low-contact, volar-angled, T-shaped buttress plate (Synthes Ltd, Paoli, PA) is used widely in the treatment of distal radius fractures. The angle of this stainless steel plate is designed to fit the angle of volar inclination of the distal radius. This design and application have been in use throughout the world for more than 20 years. Previous reports of flexor pollicis longus (FPL) tendon ruptures after placement of this type of plate have been described in patients who were chronic
steroid users.1 We report the case of a delayed rupture of the FPL after routine placement of a volar-angled T-plate for a distal radius fracture. The rupture may have occurred because of failure to conform the plate to the distal radius anatomy or because of shortening of the fracture under the buttress end of the plate, which results in a metallic edge that can chafe against the FPL.