Abstract
Introduction
We investigated the movement of the flexor pollicis longus (FPL) tendon on the distal radius during wrist and finger motions using transverse ultrasound in patients with distal radius fractures who underwent volar locking plating.
Methods
Both wrists of 39 distal radius fracture patients with volar locking plate fixation were evaluated by transverse ultrasound to examine the location of the FPL tendon on the distal radius at varied wrist positions in full finger extension and flexion.
Results
At all wrist positions during finger motion, the FPL tendon shifted significantly more dorsally on the affected side than on the unaffected side. Additionally, at the wrist dorsal flexion position with finger flexion, the FPL tendon moved significantly the most dorsally, and the distance between the FPL tendon and the plate or the radius was the smallest among all wrist positions during finger motion.
Conclusions
This study showed that the wrist dorsal flexion position with finger flexion could be the appropriate position to examine FPL tendon irritation after plating. Moreover, it would be effective for preventing FPL rupture to cover the FPL transverse gliding area approximately 10 mm radial to the vertex of the palmar bony prominence of the distal radius with the pronator quadratus and the intermediate fibrous zone.
Similar content being viewed by others
References
Asadollahi S, Keith PPA. Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature. J Orthopaed Traumatol. 2013;14:227–34.
Orbay JL, Touhami A. Current concepts in volar fixed angle fixation of unstable distal radius fractures. Clin Orthop Relat Res. 2006;445:58–67.
Soong M, Earp BE, Bishop G, et al. Volar locking plate implant prominence and flexor tendon rupture. J Bone Joint Surg. 2011;93A:328–35.
Tanaka Y, Aoki M, Izumi T, et al. Effect of distal radius volar plate position on contact pressure between the flexor pollicis longus tendon and the distal plate edge. J Hand Surg. 2011;36A:1790–7.
Cross AW, Schmidt CC. Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg. 2008;33A:164–7.
Drobetz H, Kutscha-Lissberg E. Osteosynthesis of distal radial fractures with a volar locking screw plate system. Int Orthop. 2003;27:1–6.
Kitay A, Swanstrom M, Schreiber JJ, et al. Volar plate position and flexor tendon rupture following distal radius fracture fixation. J Hand Surg. 2013;38A:1091–6.
Kameyama M, Takeda K, Komiyama T, et al. Ultrasonographic study of flexor pollicis longus tendon after volar locking plate fixation in the treatment of fractures of the distal radius. Kossetsu. 2012;34:25–8 (in Japanese).
Doi D. Ultrasonographic evaluation on flexor pollicis tendon injury after distal radius fracture using volar locking plate. J Jpn Soc Surg Hand. 2010;27:70–3 (in Japanese).
Nanno M, Sawaizumi T, Kodera N, et al. Ultrasound evaluation of the transverse movement of the flexor pollicis longus tendon on the distal radius during wrist and finger motion in healthy volunteers. J Nippon Med Sch. 2015; (in press).
Kanda T, Ohi H, Mukouda M, et al. Shift in location of flexor pollicis longus tendon after internal fixation of distal radius fracture. J Jpn Soc Surg Hand. 2013;29:510–2 (in Japanese).
Ahsan ZS, Yao J. The importance of pronator quadratus repair in the treatment of distal radius fractures with volar plating. Hand. 2012;7:276–80.
Zenzai K, Okabe S, Murata T, et al. Release of pronator quadrates at the intermediate fibrous zone in volar plating of distal radius fractures: prevention of postoperative injury of the flexor pollicis longus tendon. Orthop Surg Traumatol. 2010;53:1099–104 (in Japanese).
Shimizu H, Imatani J, Takada I, et al. Positional relationship between the distal radius and the flexor tendon. J Jpn Soc Surg Hand. 2011;27:587–9 (in Japanese).
Kanda T, Ohi H, Mukouda M, et al. Research of the positions of flexor pollicis longus tendon for preventing ruptures after volar plating for distal radius fracture. J Jpn Soc Surg Hand. 2011;27:590–4 (in Japanese).
Okamoto M, Fujisawa Y, Otsuka T, et al. Hardware-related complications of volar plating for distal radius fracture. J Jpn Soc Surg Hand. 2009;25:801–4 (in Japanese).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethical standard
Human rights statements and informed consent: all procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.
Additional informed consent was obtained from all patients for which identifying information is included in this article.
Conflict of interest
There are no financial or other relations that could lead to a conflict of interest.
About this article
Cite this article
Nanno, M., Kodera, N., Tomori, Y. et al. Transverse ultrasound assessment of the flexor pollicis longus tendon movement on the distal radius during wrist and finger motion in distal radius fracture with volar plating. J Med Ultrasonics 43, 29–36 (2016). https://doi.org/10.1007/s10396-015-0670-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10396-015-0670-0