Supernumerary extensor pollicis longus tendon masking an extensor pollicis longus rupture following non-surgical treatment of a distal radius fracture

Extensor pollicis longus tendon pathology is a recognised complication following non-surgical treatment of non-displaced distal radius fractures. Tendon entrapment typically presents with pain, but preservation of thumb retropulsion during complete rupture results in loss of active thumb retropulsio...

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Bibliographic Details
Published in:BMJ case reports 2021-07, Vol.14 (7), p.e242509
Main Authors: Wiekrykas, Bradley D, Solarz, Mark K, Abdelfattah, Hesham M, Thoder, Joseph J
Format: Article
Language:English
Subjects:
Case Report
Case reports
Female
Fingers & toes
Fractures
Humans
Middle Aged
Osteoarthritis
Pain
Pathology
Radius Fractures - surgery
Rupture
Surgery
Sutures
Tendon Injuries - etiology
Tendon Injuries - surgery
Tendon Transfer
Tendons
Tendons - surgery
Thumb - surgery
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Summary:Extensor pollicis longus tendon pathology is a recognised complication following non-surgical treatment of non-displaced distal radius fractures. Tendon entrapment typically presents with pain, but preservation of thumb retropulsion during complete rupture results in loss of active thumb retropulsion and tenodesis effect. We present the case of a 52-year-old woman who developed extensor pollicis longus tendon entrapment with full active thumb extension following a non-displaced distal radius fracture. During her elective third dorsal compartment release, the extensor pollicis longus tendon was found to be completely ruptured and a rare supernumerary extensor pollicis longus tendon was found emerging from the fourth dorsal compartment. Gentle traction of this tendon resulted in thumb interphalangeal joint extension and simultaneous index finger metacarpophalangeal joint extension. An extensor indicis proprius to extensor pollicis longus tendon transfer was performed. At her final 6-month follow-up, she had painless full active thumb motion comparable to her contralateral side.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-242509