Flexor tendon repair after rupture caused by volar plate fixation of the distal radius

Abstract

Volar plate fixation of unstable fractures of the distal radius is preferred by a majority of surgeons today. One known complication is the rupture of flexor tendons. The aim of this paper is to present flexor tendon ruptures after volar plate fixation analysing the clinical outcome after tendon surgery, aetiology, and methods of prevention. Seventeen consecutive ruptures in 14 patients were included. The incidence was 1.4%. Three patients declined tendon surgery. Eleven patients were treated with a free tendon graft. Only two patients showed excellent results regarding mobility in the thumb and/or fingers. Analysis of radiographs demonstrated sub-optimal placement of plate or screws in all cases. Rupture of a flexor tendon is a serious complication where the functional outcome after surgical reconstruction is uncertain. Early removal of the plate when the placement is sub-optimal or when local volar tenderness appears would probably prevent many ruptures.

Key Words:

• Hand
• flexor tendon
• tendon rupture
• volar plate
• outcome

Acknowledgements

We thank Professor L. Adolfsson, Department of Orthopaedics, Linköping for critically revising the manuscript and PhD Ingrid Steinvall for help with statistical advice, tables, and figures.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.