Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 23498
RUPTURE OF THE FLEXORS TENDONS AFTER VOLAR LOCKING PLATE FOR
DISTAL RADIUS FRACTURES: ABOUT 6 CASES.
Stéphanie GOUZOU, SYBILLE FACCA, Monica DIACONU, Philippe LIVERNEAUX
Hand Department - Strasbourg University, Illkirch (FRANCE)
We report 6 cases of flexor tendon ruptures, which occurred after distal radius
fracture treated by locking plate. Almost 30 other cases have been reported in the
literature since 1932. After our analysis, 5 cases of ruptures concerned the flexor
pollicis longus tendon and other tendons have been involved in one case. In our
cases, tendon’s ruptures occurred within 6 months to 4 years after surgery. We
reviewed all the patients, in order to determine the raisons of these flexor tendon
ruptures and then we proposed a surgical treatment (tendon repair and concomitant
removal of the locking plate). In 3 cases, we performed a tendon repair and a plate
removal. In 3 cases, the plate was only removed. The flexor tendon ruptures
occured, in 2 cases because of the design of the plate (too prominent), in 3 cases
because of plate’s position (too distal), and in one case because the plate was not
ajusted for the fracture reduction on a previous callus. A deformed callus after distal
radius fracture or the presence of a volar plate can lead in certain circumstances to
secondary flexor tendon tears. The mostly involved is the tendon of the flexor pollicis
longus and then the tendons of the index finger. We emphazise the importance of
initial anatomic radius reduction, in order to avoid secondary flexor tendon
complications. Moreover we propose systematic locking plate removal in dynamic
patients (less than 60 years-old) and in cases of volar wirst pain during thumb
mobilization.
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