J Korean Orthop Assoc.  2017 Aug;52(4):364-369. 10.4055/jkoa.2017.52.4.364.

Delayed Rupture of the Extensor Pollicis Longus Tendon Following Intramedullary Nailing of Radial Shaft Fracture

  • 1Department of Orthopaedic Surgery, St. Carollo Hospital, Suncheon, Korea. Lacteaa@naver.com


Delayed rupture of the extensor pollicis longus tendon mostly occur after plate fixation of distal radius fracture. However, delayed rupture of the extensor pollcis longus tendon following intramedullary nailing of radial shaft fracture is very rare. We report one case of delayed rupture of the extensor pollicis longus tendon following intramedullary nailing, presenting abnormal signs from adhesion of the extensor pollicis longus with extensor indicis at the nail insertion site.


tendon injuries; tendon transfer; radius fractures

MeSH Terms

Fracture Fixation, Intramedullary*
Radius Fractures
Tendon Injuries
Tendon Transfer


  • Figure 1 (A) Preoperative radiographs show radius shaft fracture. (B) Postoperative radiographs show the fracture treated with closed reduction and internal fixation using interlocking nail.

  • Figure 2 Ultrasonography showed loss of continuity of the extensor pollicis longus (arrow).

  • Figure 3 (A) Appearance of the distal ends of the ruptured extensor pollicis longus tendon. (B) Harvest of the extensor indicis tendon on metacarpophalangeal joint dorsal aspect. (C) The tendon transfer is done with the extensor indicis tendon.

  • Figure 4 (A) Abnormal signs included inability to extend the thumb when the second finger was in flexion. (B) But the thumb was able to be extended when the 2nd finger was in extension.

  • Figure 5 We performed adhesiolysis on the site of tendon transfer and interlocking nail insertion site.

  • Figure 6 Last follow-up. Note: full extension and dorsal elevation of thumb without extension of the 2nd finger.


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