Extensor Pollicis Longus Ruptures Following Distal Radius Osteotomy Through a Volar Approach

Rivlin, Michael; Fernández, Diego L.; Nagy, Ladislav; Graña, Gabriel López; Jupiter, Jesse B.

doi:10.1016/j.jhsa.2015.10.029

Cited by 15 publications

(10 citation statements)

References 11 publications

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“…For some, this has resulted in relatively novel complications like EPL rupture. 12 Specifically, distraction type volar osteotomy has had higher rates of complications. Haghverdian et al reported a 63% rate of complications in the distraction type volar osteotomy (15 of 24 patients) which included nonunion with volar plate failure, delayed union, and EPL rupture.…”

Section: Discussionmentioning

confidence: 99%

Simplifying the Volar Distraction Osteotomy for Distal Radius Malunion Repair

et al. 2021

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Background Extra-articular fractures of the distal radius are often treated with a trial of nonoperative management if radiographic parameters are within an acceptable range, especially in the elderly population. Unfortunately, some malunions become symptomatic or become grossly misaligned during nonoperative management which require corrective surgery to restore the normal osseous anatomy and restore function. Description of Technique We describe correction of a distal radius malunion utilizing a distraction-type volar osteotomy, a volar plate specific distraction device, and a novel resorbable calcium phosphate bone cement (Trabexus) designed to withstand compressive loads. Patients and Methods Twelve patients with 13 distal radius fractures were included in this study. The average patient age was 60.9 years and average time from injury to corrective osteotomy was 96.3 days. Radiographic measures (radial inclination, volar tilt, and ulnar variance) and clinical assessment (wrist/forearm range of motion and grip strength) were done pre- and postoperatively and compared. Results The average time from corrective surgical osteotomy to final clinical follow-up was 375.8 days. After surgical intervention, there was a statistically significant improvement in mean volar tilt (−19.8 vs. +0.5 degrees) and mean ulnar variance (+2.8 vs. −0.4 mm). Improvements were also seen in grip strength (1.7 vs. 43.6 lb), wrist flexion (30.5 vs. 48.3 degrees), wrist extension (33.3 vs. 53.8 degrees), forearm pronation (75.0 vs. 88.8 degrees), and forearm supination (53.8 vs. 81.3 degrees). On average, 56.0% of Trabexus bone substitute remained on final clinical radiographs. Conclusion This simplified technique of distraction corrective osteotomy after distal radius malunion results in improved clinical and radiographic outcomes for patients.

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Section: Discussionmentioning

confidence: 99%

Simplifying the Volar Distraction Osteotomy for Distal Radius Malunion Repair

et al. 2021

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“…Following nondisplaced fractures, compression in extensor mechanisms may occur, which may lead to mechanical compression in tendons and rupture after the formation of local ischemic areas [33, 34]. Apart from these, damage may occur in both the upper and lower extremity Achilles bone–tendon junction [35].…”

Section: Discussionmentioning

confidence: 99%

Can a Biodegradable Implanted Bilayered Drug Delivery System Loaded with BMP-2/BMP-12 Take an Effective Role in the Biological Repair Process of Bone–Tendon Injuries? A Preliminary Report

Kömür

Akyuva

Karaslan

et al. 2017

Journal of Pharmaceutics

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Background Use of biodegradable and biocompatible materials in the orthopedic surgery is gaining popularity. In this research, the rate of controlled release of a bilayered prototype biomaterial designed to promote osteoblastic and tenoblastic activity was calculated using pharmacochemical methods. Methods The first part of the design, composed of a sodium tetraborate, polyvinyl alcohol, and starch based hydrogel, was loaded with bone morphogenic protein-2. The second part which was composed of a sodium tetraborate, polyvinyl alcohol, and chitosan based hydrogel was loaded with bone morphogenic protein-12. Osteochondral and tendon tissue specimens were obtained from patients with a diagnosis of gonarthrosis and primary bone cells and tendon cells cultures were prepared following treatment with collagenase enzyme. Cell samples were collected from the groups by means of an invert light microscope and environmental scanning electron microscope underwent at the 1st and 21st days. The level of osteogenic differentiation was measured by the activity of alkaline phosphatase. For the statistical evaluation of the obtained data, groups were compared with post hoc Tukey test following analysis of variance. Level of significance was accepted to be <0,01. Results Both osteogenic and tenogenic stimulation were observed in the cultured specimens. In comparison to the control groups, the rate of proliferation of healthy cells was found to be higher in the groups to which the design was added (p < 0.01). Conclusions Our research is a preliminary report that describes a study conducted in an in vitro experimental setting. We believe that such prototype systems may be pioneers in targeted drug therapies after reconstructional surgeries.

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“…The complication rate was higher in patients who had a distraction-type osteotomy compared with those who had an osteotomy hinged on the volar cortex. Rivlin and colleagues 42 reported on 6 patients with extensor pollicis rupture after osteotomy and volar plate fixation for MDRF. Average time to tendon rupture was 10 weeks after surgery.…”

Section: Complicationsmentioning

confidence: 99%

Distal Radius Malunion

Katt

Seigerman

Lutsky

et al. 2020

The Journal of Hand Surgery

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Malunion remains the most common complication of nonsurgical treatment of fractures of the distal radius and represents a common clinical entity. Symptomatic treatment often involves corrective osteotomy. Surgical correction is a challenging problem with unpredictable clinical outcomes. Prevention of malunion of a distal radius fracture is the best course of action. With maintenance of volar cortical contact and the use of volar fixed-angle devices, bone grafting may not be necessary in certain cases of malunion correction. New technologies such as 3dimensional modeling and computer-generated osteotomy guides are likely to have a positive impact on the outcomes of surgical treatment.

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Extensor Pollicis Longus Ruptures Following Distal Radius Osteotomy Through a Volar Approach

Cited by 15 publications

References 11 publications

Simplifying the Volar Distraction Osteotomy for Distal Radius Malunion Repair

Simplifying the Volar Distraction Osteotomy for Distal Radius Malunion Repair

Can a Biodegradable Implanted Bilayered Drug Delivery System Loaded with BMP-2/BMP-12 Take an Effective Role in the Biological Repair Process of Bone–Tendon Injuries? A Preliminary Report

Distal Radius Malunion

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