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.
Keywords
distal radius fracture - tendon entrapment - computed tomography - AO-OTA classification
