Changes in the Rate of Postoperative Flexor Tendon Rupture in Patients with Distal Radius Fractures

Abstract

Background: Flexor tendon rupture is a major complication after volar locking plating for distal radius fracture (DRF). Few studies have investigated changes in the rate of postoperative flexor tendon rupture in patients with DRFs. The present study aimed to investigate the changes in the rate of postoperative flexor tendon rupture and to assess plate placement and reduction positions. Methods: We retrospectively reviewed patients in whom more than 24 months had passed since DRF surgery. The patients were interviewed by telephone. Forty-nine patients (50 fractures; 2007–2009) from institution A were included in group 1 and 81 patients (84 fractures; 2013–2016) from institution B were included in group 2. The DRF surgery method was similar between the two groups. The rate of flexor tendon rupture, Soong classification grade, and radiological index (i.e., volar tilt [VT], radial inclination [RI], and ulnar variance [UV]) were statistically investigated in both groups. Results: Patient epidemiology was not significantly different between the two groups. The flexor tendon rupture rates were 2% and 0% in groups 1 and 2, respectively, without a significant difference. With regard to the Soong grade, 44 fractures were grade 2 and 6 were grade 1 in group 1, whereas 18 were grade 2, 38 were grade 1, and 28 were grade 0 in group 2, with a significant difference (p < 0.05). With regard to the radiological index, the mean VT values were 5° and 11° in groups 1 and 2, respectively, with a significant difference (p < 0.05). However, RI and UV showed no significant difference. Conclusions: Plate placement and reduction positions, which are risk factors for flexor tendon ruptures after DRFs, have improved recently when compared with previous findings. With these changes, the rate of flexor tendon rupture is presumed to have decreased.

Pronator quadratus repair after volar plating for distal radius fractures: A systematic review and meta-analysis of randomized controlled trials

“…Furthermore, it may be more important to consider the Soong index in accurate plate positioning as this has been shown to correlate to the rate of plate removal and tendon damage. 12 - 14 Additionally, Parthak et al 15 found in the early postoperative period that PQ repair may result in reduced pain levels which may be from protecting these tendons in the early postoperative period. Overall, RCTs may not be appropriate to assess the potential benefit of plate coverage as they may be drastically underpowered to assess this uncommon but clinically important complication, large-scale population-based studies thus may be more appropriate.…”