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Risk Factors of Flexor Tendon Rupture After ORIF of Distal Radius Fracture

Authors
Kwon, Young WooChoi, In CheulKim, MyongwhanNam, Jae JunPark, Jong Woong
Issue Date
Mar-2023
Publisher
Lippincott Williams & Wilkins Ltd.
Keywords
distal radius fracture; flexor tendon rupture; volar plate; malreduction; plate position
Citation
Journal of Orthopaedic Trauma, v.37, no.3, pp E99 - E103
Indexed
SCIE
SCOPUS
Journal Title
Journal of Orthopaedic Trauma
Volume
37
Number
3
Start Page
E99
End Page
E103
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/62702
DOI
10.1097/BOT.0000000000002498
ISSN
0890-5339
1531-2291
Abstract
Objectives To analyze the risk factors associated with postoperative flexor tendon rupture, after a volar plate fixation of distal radius fractures. Design Retrospective observational case–control study. Setting Tertiary Care University Hospital in the Republic of Korea (2009–2020). Patients Sixteen referred patients were treated for flexor tendon rupture, following previously performed volar plating of distal radius fractures at other institutions. 16 patients were randomly selected from our database as controls, and were matched based on the Soong grade of the case group. Intervention Not applicable. Main Outcome Measurements Radial tilt and radial height were measured on anteroposterior radiographs. The volar tilt, tear drop angle, carpal translation, and Soong grade were measured in a lateral view. Results Quantitative measurements of the volar tilt, carpal translation, and tear drop angle were positively correlated with the flexor tendon rupture. The mean volar tilt and tear drop angle in the tendon rupture group were significantly smaller than those in the control group. The mean carpal translation in the tendon rupture group was significantly greater than that in the control group. Conclusions This study demonstrated that volar tilt, carpal translation, and tear drop angle are significant risk factors for flexor tendon rupture, especially for plates placed at Soong grade 1 or 2. We suggest that the potential for tendon rupture because of incomplete reduction of the distal radius fracture along with implant prominence volar to the watershed line aggravates flexor tendon irritation at the distal edge of the plate because of distorted flexor tendon paths. Level of Evidence Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Choi, In Cheul
Anam Hospital (Department of Orthopedic Surgery, Anam Hospital)
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