Rupture of Flexor Pollicis Longus Tendon: A Complication of Volar Locking Plating of the Distal Radius

Rajeev, Aysha; Sreverthana, Shanaka; Harrison, John W.

doi:10.1007/s00068-009-9021-4

Cited by 6 publications

(6 citation statements)

References 8 publications

(14 reference statements)

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“…The 3D polygon mesh reconstructions were subsequently imported into rhinoceros (McNeel, Seattle, WA) to quantify (1) the most prominent line of points of the volar aspect of the radius, (2) the radial and ulnar osseous prominences, and (3) distances between RSA soft tissue landmarks 8,12-15 and Q3DCT-defined osseous landmarks [1][2][3][4][5][6][7][17][18][19][20][21][22][23][24][25][26][27] (►Fig. 3A).…”

Section: Soft Tissue Landmarksmentioning

confidence: 99%

The Watershed Line of the Distal Radius: Cadaveric and Imaging Study of Anatomical Landmarks

et al. 2019

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Background Placement of volar plates remains a challenge as the watershed line may not be an easy-identifiable distinct line intraoperatively. Objectives The main objective of this article is to define how anatomical landmarks identifiable upon the volar surgical approach to the distal radius relate to the watershed line. Methods We identified anatomical landmarks macroscopically upon standard volar approach to the distal radius in 10 cadaveric forearms and marked these with radiostereometric analysis (RSA) beads in cadaveric wrists. The RSA beads were then referenced against the volar osseous structures using quantification of three-dimensional computed tomography and advanced imaging software. Results The mean measurements were the radial and ulnar prominences 11.1 mm and 2.1 mm proximal to the joint line of the distal radius, respectively. The interfossa sulcus was 0.3 mm proximal and 3 mm dorsal to the ulnar prominence. The watershed line was between 3.5 (minimal) and 7.6 (maximal) mm distal to the distal line of insertion of the pronator quadratus. Conclusion The watershed line is situated distal to the pronator quadratus, but with a wide variability making it an impractical landmark for plate position. The osseous ulnar prominence is a good anatomical reference for safe plate positioning, as it is located on the watershed line and easily palpated at surgery. One should keep in mind the sulcus—the point on the watershed line where the flexor pollicis longus runs—can be situated just proximal to the ulnar prominence. Clinical Relevance To provide anatomical landmarks that are easy to identify upon surgical approach without the direct need for intraoperative imaging.

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Section: Soft Tissue Landmarksmentioning

confidence: 99%

The Watershed Line of the Distal Radius: Cadaveric and Imaging Study of Anatomical Landmarks

et al. 2019

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“…Four of these were case series describing tendon injury. 21,34,35,43 Five studies were imaging studies, 22,31,36,44,45 four analyzing the anatomy of the distal radius, and one analyzing the relation between the distal radius and plate fit. Two retrospective studies and one prospective study analyzed the outcome after volar plating for distal radius fractures.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…In general, after comparing all descriptions, "the watershed line" could be divided into the following categories: (1) interpretations that are based on soft tissue landmarks 22,[30][31][32][33] and (2) interpretations using bony landmarks as the main anatomic reference. 11,17,[19][20][21]23,24,[26][27][28][34][35][36][37][38][39][40][41] Within these two categories, we found eight different interpretations of the term "watershed line." Two descriptions made use of soft tissue landmarks which were (7) "the distal border of the pronator quadratus" [30][31][32][33] and A theoretical line marking the most volar aspect of the distal radius 11,20,34,35 2…”

Section: Study Characteristicsmentioning

confidence: 99%

“…(8) "the origin of the volar carpal ligaments." 22 The descriptions using bony landmarks could further be subdivided into anatomical characterizations (i.e., descriptions in which the watershed line is interpreted as a distinguishable anatomical line) 11,20,28,[34][35][36][37] and surgical characterizations (i.e., descriptions which are purely reflecting the optimal location of the volar plate). 17,19,21,23,24,26,[38][39][40] We found three different anatomical descriptions and two different surgical descriptions using bony landmarks.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…One characterization combined both the anatomical and the surgical description. The three anatomical descriptions using bony landmarks were (1) "a theoretical line marking the most volar aspect of the distal radius," 11,20,34,35 (2) "the distal radial physeal scar," 36,37 and (3) "the most distal edge of the epiphysis" 28 . The two surgical descriptions using bony landmarks were (4) "the ridge that distally limits the concave profile of the pronator fossa" 17,19,21,23,24,26,38,39 and (5) "the ulnar prominence."…”

Section: Study Characteristicsmentioning

confidence: 99%

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Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

et al. 2019

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Objective The objective of this systematic review is to provide an overview of all interpretations of the definition of the watershed line used in literature. Methods The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed for this review. A comprehensive search was performed for definitions of the watershed line given in literature. A total of 32 studies giving an explicit interpretation of the definition of the watershed line or anatomical reference for plate positioning in writing and/or imaging were included. Results In 32 studies, we found eight different landmarks used to refer to the watershed line or correct plate positioning. Five studies used two different soft tissue landmarks. Six different bony landmarks were described in 24 studies. These could further be subdivided into three anatomical interpretations, described in seven studies, in which the term “watershed line” is explained as a distinguishable anatomical line, and two surgical interpretations, described in 15 studies, which are purely reflecting the optimal location of the volar plate. One interpretation of the watershed line described in two studies combined both anatomical and surgical landmarks. Conclusion The (mis)interpretation of the definition of the term “watershed line” as described by Orbay is subject to the type of landmarks and purpose used: soft tissue or bony landmarks and an anatomical or a surgical purpose. A clear distinction can be made between interpretations using bony landmarks, as the true watershed line is defined and definitions using soft tissue landmarks, which might represent the reference points surgeons use in clinical practice.

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Location of distal pronator quadratus repair in distal radius fractures: A cadaveric biomechanical study

Stewart

Lee

Wellington

et al. 2023

Clinical Biomechanics

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Rupture of Flexor Pollicis Longus Tendon: A Complication of Volar Locking Plating of the Distal Radius

Cited by 6 publications

References 8 publications

The Watershed Line of the Distal Radius: Cadaveric and Imaging Study of Anatomical Landmarks

The Watershed Line of the Distal Radius: Cadaveric and Imaging Study of Anatomical Landmarks

Interpretations of the Term “Watershed Line” Used as Reference for Volar Plating

Location of distal pronator quadratus repair in distal radius fractures: A cadaveric biomechanical study

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