Ultrasonic Evaluation of the Flexor Pollicis Longus Tendon Following Volar Plate Fixation for Distal Radius Fractures

• Published in: The Journal of hand surgery (American ed.) Vol. 41; no. 3; pp. 374 - 380
• Main Authors: Kara, Adnan, MD, Celik, Haluk, MD, Bankaoglu, Mujdat, MD, Oc, Yunus, MD, Bulbul, Murat, MD, Sugun, Tahir Sadık, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2016
• Subjects: Adult; Aged; Bone Plates; Distal radius fracture; Female; flexor tendon complications; Fracture Fixation, Internal; Humans; Male; Middle Aged; Orthopedics; Postoperative Complications - diagnostic imaging; Radius Fractures - surgery; Retrospective Studies; Tenosynovitis - diagnostic imaging; ultrasonic evaluation; volar plating; watershed line; Wrist Joint - diagnostic imaging; watershed line; volar plating; flexor tendon complications; ultrasonic evaluation; Distal radius fracture
• ISSN: 0363-5023; 1531-6564
• DOI: 10.1016/j.jhsa.2015.11.022

Purpose To evaluate with ultrasound the thickness of the flexor pollicis longus (FPL) tendon and its relationship to the volar locking plate after the fixation of distal radius fractures. Methods We evaluated 27 type C2 and C3 distal radius fractures with ultrasound to evaluate damage to the FPL tendon after volar plate fixation. The thickness of the FPL tendon and its distance to the volar plate in the involved wrists and to the volar rim in the contralateral uninjured wrist were measured on sonograms taken 12 months postoperatively. Measurements of the involved wrists were compared with those of the intact wrists. Results The mean plate-tendon distance in the involved wrist was considerably shorter than the mean volar rim-tendon distance in the intact wrist, and the FPL tendon was considerably thicker in the involved wrist than in the intact wrist. Conclusions In distal radial fractures treated with volar locking plates, increases in the thickness of the FPL tendon and a consequent decrease in the distance between the tendon and the plate can be determined with ultrasonography. This finding is a warning that asymptomatic tenosynovitis may eventually cause tendon ruptures. Type of study/level of evidence Diagnostic IV.