Sehnenrupturen in der Folge distaler Radiusfrakturen

After distal radial fractures, closed ruptures of the extensor pollicis longus (EPL) tendon may be caused by protruding screws of a volar plate but also occur after conservative fracture treatment. The time interval between accident and rupture is a few weeks to a few months. Tendon transfer of the extensor indicis tendon or a tendon interposition graft are good options for reconstruction. Fusion of the IP joint is not a solution, as the second function of the EPL tendon is to withdraw the thumb ray out of volar abduction. Closed ruptures of the flexor pollicis longus (FPL) tendon exclusively occur after volar plate ORIF, the time interval being years to more than a decade. Volar plates of the distal radius should generally be removed after bone healing and urgently when the patient reports tendon crepitation or pain. A ruptured FPL tendon may be reconstructed by tendon interpositional graft or by tendon transfer but IP joint fusion is a good alternative as the flexor pollicis brevis muscle shows a good thumb metacarpophalangeal joint flexion.