Although extensor tendon rupture often occurs after volar plating for a distal radius fracture, a flexor tendon rupture is extremely rare. Most reported instances of flexor tendon ruptures after volar plating have involved improper placement of the plate, increased prominence of the distal edge of the plate because of collapse of the fracture site, use of custom-made plates, current steroid use by the patient, or a history of tendon injury. We report a case of delayed rupture of the flexor pollicis longus tendon 40 months after volar plating with a 3.5-mm T-locking compression plate for which the distal edge was located at the transverse ridge level of the distal radius. If symptoms such as tendon irritation occur in this situation, surgeons should consider removing the plate as soon as possible after bony union is achieved.
*Bone Plates ; Female ; Fracture Fixation, Internal/*methods ; Humans ; Middle Aged ; Radius Fractures/*complications/pathology/*surgery ; Rupture ; Tendon Injuries/*etiology/*surgery ; Thumb/physiopathology

OBJECTIVETo analyze the cause of the postoperative shortening in distal radius fractures and to find treatment strategies to enhance the reduction effect of distal radius fracture and long-term efficacy.

METHODSFrom June 2005 to January 2009, 46 patients with distal radius fractures were treated by surgical operation including 17 males and 29 females,ranging from 27 to 90 years old with an average age of 48 years. All fractures were reduced satisfactory with smooth articular surface. The postoperative radial shortening was analyzed.

RESULTSAll patients were followed-up for 6 to 24 months with an average of 14 months. Among them, 12 patients had radial shortening. The causes of postoperative radial shortening includes: (1) patients older than 60 years; (2) severe osteoporosis; (3) preoperative displacement and comminuted fractures; (4) inappropriate fixation methods; (5) inadequate bone graft; (6) premature load.

CONCLUSIONThe key points to enhance the treatment outcomes include precise judgement of the fracture type and bone quality, sufficient bone graft, firmly fixed after anatomical reduction and an appropriate plan for early loadless functional exercise. Traumatic arthritis may be avoided or delayed if the above-mentioned six causes can be taken into consideration or preventive measures can be taken.

Adult ; Age Factors ; Aged ; Aged, 80 and over ; Bone Transplantation ; Female ; Follow-Up Studies ; Fracture Fixation ; Humans ; Male ; Middle Aged ; Osteoporosis ; etiology ; Postoperative Complications ; etiology ; therapy ; Radius ; pathology ; Radius Fractures ; surgery