J Wrist Surg 2020; 09(02): 129-135
DOI: 10.1055/s-0039-3402424
Scientific Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Extensor Tendon Entrapment on Computed Tomography Imaging of Distal Radius Fractures

Evan D. Nigh
1   Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California
,
Christopher P. Emerson
2   Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, Florida
,
David To
3   Department of Radiology, Jackson Memorial Hospital, Miami, Florida
,
Spencer Barnhill
4   Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida
,
Michael G. Rizzo
4   Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida
,
Duc M. Nguyen
4   Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida
,
Ane Ugarte
5   Department of Radiology, Hospital Universitario Donostia, San Sebastian, Spain
,
Felipe Muñera
4   Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida
,
Dylan N. Greif
4   Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida
,
Jean Jose
3   Department of Radiology, Jackson Memorial Hospital, Miami, Florida
,
Seth D. Dodds
4   Department of Orthopaedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, Florida
› Author Affiliations
Further Information

Publication History

20 August 2019

13 November 2019

Publication Date:
24 December 2019 (online)

Abstract

Objective To examine the association between distal radius fractures and tendon entrapment identified on computed tomography (CT) imaging.

Patients and Methods After Institutional Review Board approval, we retrospectively reviewed distal radius fractures that underwent CT imaging from an electronic database between January 2006 to February 2018 at a single level 1 hospital trauma center. We categorized all distal radial fractures according to the AO-OTA (AO Foundation/Orthopaedic Trauma Association) classification. Distal upper extremity tendons were assessed for entrapment. Fisher's exact test was used for statistical analysis with significance at p < 0.05.

Results A total of 183 distal radius fractures were identified in 179 patients. A total of 16 fractures (13 males and 3 females) were associated with tendon entrapment. Mechanism of injury included falls (n = 7), motor vehicle accidents (n = 6), dog bites (n = 2), and gunshot wound (n = 1). Entrapped tendons were limited to the extensor compartment and included the extensor pollicis longus (EPL; n = 11), extensor pollicis brevis (n = 1), extensor carpi ulnaris (n = 1), extensor carpi radialis longus (n = 1), and extensor digitorum communis (n = 2). The most commonly associated AO-OTA fracture pattern with tendon entrapment was complete articular radial fractures (2R3C; 69%), eight of which were simple articular with metaphyseal multifragmentary fractures (2R3C2). Of the distal radius fractures, 81% were associated with additional ulnar fractures of varying severity and displacement.

Conclusion Approximately 8.7% of distal radius fractures were retrospectively identified to have tendon entrapment compared with a previously reported incidence of 1.3%. Wrist surgeons and radiologists should have higher suspicion for tendon entrapment and carefully review preoperative CT imaging for tendon entrapment in distal radius fractures especially if there is an intra-articular, multifragmentary injury pattern. Wrist surgeons and radiologists should also have increased suspicion for EPL tendon entrapments given its high incidence in association with distal radius fractures.

Level of Evidence This is a Level III, retrospective cross-sectional study.

Note

The study was performed at the University of Miami Miller School of Medicine, Miami, FL, Sports Medicine Institute, University of Miami Miller School of Medicine, Coral Gables, FL, and Department of Radiology, Hospital Universitario Donostia, San Sebastian, Spain.


Ethical Review Statement

The study was exempted on the grounds of retrospective chart review.