J Korean Soc Surg Hand.  2015 Mar;20(1):23-27. 10.12790/jkssh.2015.20.1.23.

Failed Extensor Indicis Proprius Tendon Transfer for Extensor Pollicis Longus Tendon Rupture after Distal Radial Fracture

  • 1Department of Orthopaedic Surgery, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea. yougunwon@gmail.com
  • 2Department of Medicine, Yonsei University Graduate School, Seoul, Korea.


Open reduction and internal fixation using volar plating for the treatment of distal radial fractures (DRFs) is becoming an increasingly popular method. Tenosynovitis of extensor tendons causes delayed extensor pollicis longus (EPL) tendon rupture which known as complication following screw penetration of the dorsal cortex after volar plating for DRFs. As the reconstructive procedure for a closed ruptured EPL tendon in minimal displaced DRF, extensor indicis proprius (EIP) transfer is widely used. However, tendon injuries of the fourth compartment, which includes the extensor digitorum communis or EIP, can be caused by screw irritation after volar plating for DRFs. We encountered a rare case of failed EIP tendon transfer for delayed EPL tendon rupture after volar plating for a DRF. Because the EIP tendon can also be damaged by screw penetration, care must be taken to use EIP tendon for treatment of delayed EPL rupture after volar plating for DRFs.


Extensor indicis proprius; Distal radius fracture; Tendon transfer; Volar plate fixation

MeSH Terms

Tendon Injuries
Tendon Transfer*


  • Fig. 1. (A, B) Radiograph showing a healed distal radius fracture and screws with extra length.

  • Fig. 2. (A, B) Surgical exploration revealing the penetrated tips of screws and a frayed extensor pollicis longus tendon rupture over the distal edge.

  • Fig. 3. (A) Intact coupling of the EIP and EPL tendon. (B) A rupture can be seen proximal to the EIP tendon. (C) PL tendon transfer to the EPL. EIP, extensor indicis proprius; EPL, extensor pollicis longus.



1. urner RG, Faber KJ, Athwal GS. Complications of distal radius fractures. Hand Clin. 2010; 26:85–96.
2. Esenwein P, Sonderegger J, Gruenert J, Ellenrieder B, Tawfik J, Jakubietz M. Complications following palmar plate fixation of distal radius fractures: a review of 665 cases. Arch Orthop Trauma Surg. 2013; 133:1155–62.
3. Benson EC, DeCarvalho A, Mikola EA, Veitch JM, Moneim MS. Two potential causes of EPL rupture after distal radius volar plate fixation. Clin Orthop Relat Res. 2006; 451:218–22.
4. Al-Rashid M, Theivendran K, Craigen MA. Delayed ruptures of the extensor tendon secondary to the use of volar locking compression plates for distal radial fractures. J Bone Joint Surg Br. 2006; 88:1610–2.
5. Davis DI, Baratz M. Soft tissue complications of distal radius fractures. Hand Clin. 2010; 26:229–35.
6. Singh HP, Srinivasan S, Ullah A. Closed rupture of the extensor indicis and extensor digitorum tendons to the index finger after locking plate fixation of a fracture of the distal radius. J Hand Surg Eur Vol. 2013; 38:86–7.
7. Hattori Y, Doi K, Sakamoto S, Yukata K. Delayed rupture of extensor digitorum communis tendon following volar plating of distal radius fracture. Hand Surg. 2008; 13:183–5.
8. de Boer SW, van Kooten EO, Ritt MJ. Extensor pollicis longus tendon rupture with concomitant rupture of the extensor digitorum communis II tendon after distal radius fracture. J Hand Surg Eur Vol. 2010; 35:679–81.
9. Arora R, Lutz M, Hennerbichler A, Krappinger D, Espen D, Gabl M. Complications following internal fixation of unstable distal radius fracture with a palmar locking-plate. J Orthop Trauma. 2007; 21:316–22.
10. Leversedge FJ, Srinivasan RC. Management of soft-tissue injuries in distal radius fractures. Hand Clin. 2012; 28:225–33.
11. Sadr B. Sequential rupture of extensor tendons after a Colles fracture. J Hand Surg Am. 1984; 9:144–5.
Full Text Links
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr