Hiroshi Yamazaki1, Shigeharu Uchiyama2, Masatoshi Komatsu3, Shun Hashimoto3, Hiroyuki Kato2. 1. Department of Orthopaedic Surgery, Aizawa Hospital, Matsumoto, Japan. Electronic address: hiroshiymzk1017@ybb.ne.jp. 2. Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan. 3. Department of Orthopaedic Surgery, Aizawa Hospital, Matsumoto, Japan.
Abstract
PURPOSE: To identify risk factors for tendon attrition after volar locking plate fixation of distal radius fractures. METHODS: We prospectively assessed attrition of the flexor pollicis longus tendon at volar plate removal in 127 hands in 126 patients. We also evaluated preoperative lateral wrist radiographs, sonographs, and crepitus with flexor pollicis longus tendon motion and compared the demographic and radiographic characteristics of patients with and without tendon attrition. Multivariate logistic regression analysis was employed to identify the factors independently associated with tendon attrition. RESULTS: We found 12 cases of tendon attrition (10%) and 1 that presented with tendon rupture in our cohort. Crepitus was recognized in 14 patients (11%): 6 cases (50%) were among the 12 hands in 12 patients with tendon attrition whereas 8 (7%) were detected in the remaining 114 hands in 113 patients. Logistic regression examination revealed that audible crepitus and volar placement of the plate in lateral radiographs were independent predictors of tendon attrition. CONCLUSIONS: Crepitus and volar placement of hardware in lateral radiographs were independent risk factors for flexor tendon attrition after volar plating for distal radius fracture. These results may facilitate surgical decisions regarding early plate removal to prevent possible tendon rupture. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
PURPOSE: To identify risk factors for tendon attrition after volar locking plate fixation of distal radius fractures. METHODS: We prospectively assessed attrition of the flexor pollicis longus tendon at volar plate removal in 127 hands in 126 patients. We also evaluated preoperative lateral wrist radiographs, sonographs, and crepitus with flexor pollicis longus tendon motion and compared the demographic and radiographic characteristics of patients with and without tendon attrition. Multivariate logistic regression analysis was employed to identify the factors independently associated with tendon attrition. RESULTS: We found 12 cases of tendon attrition (10%) and 1 that presented with tendon rupture in our cohort. Crepitus was recognized in 14 patients (11%): 6 cases (50%) were among the 12 hands in 12 patients with tendon attrition whereas 8 (7%) were detected in the remaining 114 hands in 113 patients. Logistic regression examination revealed that audible crepitus and volar placement of the plate in lateral radiographs were independent predictors of tendon attrition. CONCLUSIONS: Crepitus and volar placement of hardware in lateral radiographs were independent risk factors for flexor tendon attrition after volar plating for distal radius fracture. These results may facilitate surgical decisions regarding early plate removal to prevent possible tendon rupture. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.