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Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years
INTRODUCTION: Spontaneous ruptures of extension pollicis longus tendon predominantly occur after undisplaced or minimally displaced distal radial fracture near Lister tubercle. Systemic inflammatory diseases and systemic or local steroid, mechanical causes like bony ridges, presence of bone plate or...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Indian Orthopaedic Research Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245929/ https://www.ncbi.nlm.nih.gov/pubmed/28116261 http://dx.doi.org/10.13107/jocr.2250-0685.486 |
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author | Pal, Jitendra Nath Bera, Amiya Kumar Roy, Amarendra Nath Bari, Wasim |
author_facet | Pal, Jitendra Nath Bera, Amiya Kumar Roy, Amarendra Nath Bari, Wasim |
author_sort | Pal, Jitendra Nath |
collection | PubMed |
description | INTRODUCTION: Spontaneous ruptures of extension pollicis longus tendon predominantly occur after undisplaced or minimally displaced distal radial fracture near Lister tubercle. Systemic inflammatory diseases and systemic or local steroid, mechanical causes like bony ridges, presence of bone plate or external fixator pin may precipitate this. Repetitive uses in certain occupation like cooking, cow milking, tailoring and direct trauma in kick boxer are also identified as cause. In this study it is caused by screw tip that also after 20 years. Instead of tendon transfer, interposition tendon grafting is preferred. CADE PRESENTATON: A 36-year-old male manual worker was plated for distal radial shaft fracture of left side. Distal most screw length was 3 mm in excess. After 20 years he developed rupture of extensor pollicislongus spontaneously. After excluding probable other causes and confirming by USG tendon ends were explored through dorsal incision. Offending slotted head screw was removed using hollow mill. Ipsilateral Palmaris longus tendon was grafted. Tension was set by extension of thumb and neutral position of the wrist. Removal of stitch after 2 weeks, short arm cast immobilization for 6 week and intermittent splinting and exercises for another 6 weeks yield excellent result. CONCLUSION: Timely removal of implant when it is applied over tendon rich areas is preferable. In late situation surgeon should be equipped and careful to remove it. To avoid chance of transferring a diseased tendon interposition grafting using Palmaris longus is justified. |
format | Online Article Text |
id | pubmed-5245929 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Indian Orthopaedic Research Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-52459292017-01-23 Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years Pal, Jitendra Nath Bera, Amiya Kumar Roy, Amarendra Nath Bari, Wasim J Orthop Case Rep Case Report INTRODUCTION: Spontaneous ruptures of extension pollicis longus tendon predominantly occur after undisplaced or minimally displaced distal radial fracture near Lister tubercle. Systemic inflammatory diseases and systemic or local steroid, mechanical causes like bony ridges, presence of bone plate or external fixator pin may precipitate this. Repetitive uses in certain occupation like cooking, cow milking, tailoring and direct trauma in kick boxer are also identified as cause. In this study it is caused by screw tip that also after 20 years. Instead of tendon transfer, interposition tendon grafting is preferred. CADE PRESENTATON: A 36-year-old male manual worker was plated for distal radial shaft fracture of left side. Distal most screw length was 3 mm in excess. After 20 years he developed rupture of extensor pollicislongus spontaneously. After excluding probable other causes and confirming by USG tendon ends were explored through dorsal incision. Offending slotted head screw was removed using hollow mill. Ipsilateral Palmaris longus tendon was grafted. Tension was set by extension of thumb and neutral position of the wrist. Removal of stitch after 2 weeks, short arm cast immobilization for 6 week and intermittent splinting and exercises for another 6 weeks yield excellent result. CONCLUSION: Timely removal of implant when it is applied over tendon rich areas is preferable. In late situation surgeon should be equipped and careful to remove it. To avoid chance of transferring a diseased tendon interposition grafting using Palmaris longus is justified. Indian Orthopaedic Research Group 2016 /pmc/articles/PMC5245929/ /pubmed/28116261 http://dx.doi.org/10.13107/jocr.2250-0685.486 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc-sa/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-sa/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Pal, Jitendra Nath Bera, Amiya Kumar Roy, Amarendra Nath Bari, Wasim Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years |
title | Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years |
title_full | Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years |
title_fullStr | Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years |
title_full_unstemmed | Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years |
title_short | Palmaris Longus Tendon Grafting for Extensor Pollicis Longus Tendon Rupture bScrew Tip after 20 years |
title_sort | palmaris longus tendon grafting for extensor pollicis longus tendon rupture bscrew tip after 20 years |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5245929/ https://www.ncbi.nlm.nih.gov/pubmed/28116261 http://dx.doi.org/10.13107/jocr.2250-0685.486 |
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