Incidence of extensor pollicis longus tendon rupture after nondisplaced distal radius fractures

Purpose: The incidence of extensor pollicis longus (EPL) tendon rupture in the setting of nondisplaced distal radius fractures is unknown. Extensor pollicis longus rupture is a known complication after distal radius fractures and is believed to occur more frequently after minimally displaced and nondisplaced distal radius fractures. Our study sought to define the incidence of EPL tendon rupture after nondisplaced distal radius fractures presenting to a level 1 trauma center.

Methods: Using our billing database, we identified distal radius fractures presenting to our institution between 2006 and 2009. We reviewed injury radiographs to identify fractures in which radiographic measurements were within predefined radiographic norms. Two fellowship-trained orthopedic hand surgeons, 1 fellowship-trained musculoskeletal radiologist, and 1 senior orthopedic surgery resident then reviewed these fractures. Only those fractures thought by all 4 reviewers to be nondisplaced were classified as nondisplaced for the purposes of this study. We then reviewed charts of these nondisplaced fractures to identify patients who subsequently sustained an EPL tendon rupture.

Results: We identified 3 EPL ruptures out of 61 nondisplaced fractures (5%). These occurred at an average of 6.6 weeks after distal radius fractures.

Conclusions: The incidence of EPL rupture is higher than previously reported in the literature.

Type of study/level of evidence: Therapeutic IV.