J Korean Fract Soc.  2013 Jan;26(1):65-68. 10.12671/jkfs.2013.26.1.65.

Interposition of Extensor Pollicis Longus Tendon in Smith's Fracture in a Child: A Case Report

• Jeon SJ
• Noh HK
• Kim DY
• Jung SH
• Shin JB
• Jeon HS

• KMID: 1431720
• DOI: http://doi.org/10.12671/jkfs.2013.26.1.65

Abstract

Entrapment of the extensor pollicis longus tendon is reported rarely on Smith's fractures in children. In our case, a 15 year old boy with Smith's fracture received treatment of closed reduction at another hospital. When he visited our hospital, a wide gap at the fracture site was detected on radiograph and the thumb movement was limited. We have doubt the entrapment of the soft tissue, especially the tendon. We decided on open reduction. In the operation field, entrapment of the extensor pollicis longus tendon at the gap of the fracture site was found through dorsal approach. In addition, fracture treatment with K-wire fixation after reduction of extensonr pollicis longus tendon reduction was done. Therefore, we report this case with a review of the literatures.

Keyword

Extensor pollicis longus tendon; Smith's fracture; Entrapment of EPL tendon; Open reduction

MeSH Terms

Child
Humans
Tendons
Thumb

Figure

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  Fig. 1 (A) Initial radiograph of the right wrist shows severe displacement of distal fracture fragment toward the volar side in Smith's fracture. (B) Radiographs after reduction.

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  Fig. 2 Preoperative computed tomography scan of the right wrist shows persistent gap at the fracture site after reduction.

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  Fig. 3 The distal portion of extensor pollicis longus (EPL) tendon is found, but proximal portion is not seen (red arrow). EPL goes through a gap of fracture site and towards the dorsal side of the fracture site where it used to go through the proximal facture site.

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  Fig. 4 The intraoperative photographs after reduction of the extensor pollicis longus (EPL) tendon (blue arrow). Fractured cortical bone fragment was reduced (red arrow). Entrapted EPL tendon was reduced from volar side to dorsal side.

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  Fig. 5 (A, B) Open reduction and internal fixation with Kirschner wires was done.

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