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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Flexor Pollicis Longus Tendon Rupture after Volar Plate Fixation of Distal Radius Fracture

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  • presenting/speaker Daiki Yamamoto - Department of Orthopedic surgery, Keiju Medical Center, Nanao City, Ishikawa, Japan
  • Kaoru Tada - Department of Orthopaedic Surgery, Kanazawa University, Kanazawa City, Ishikawa, Japan

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-927

doi: 10.3205/19ifssh0594, urn:nbn:de:0183-19ifssh05944

Published: February 6, 2020

© 2020 Yamamoto et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

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Objectives/Interrogation: Flexor pollicis longus (FPL) tendon rupture is known as a complication after volar plate fixation of distal radius fracture caused by volar plate prominence. We experienced some cases of FPL tendon rupture without plate prominence significantly, so we evaluated other risk factors of FPL tendon rupture.

Methods: Patients who had been undergone volar plate fixation for distal radius fracture between 2006 and 2012 were included in this case-control study. Eight patients with FPL tendon rupture (case group) and forty-five patients who were observed for more than two years without hardware removal (control group) were included. All patients were female. We investigated age, body height and weight, range of motion of the operated wrist, medical history of rheumatoid arthritis and diabetes mellitus, history of oral administration of steroids, smoking, and alcohol use in the patients. Post-operative X-rays were used to identify parameters of reduction (volar tilt, radial inclination, and ulnar variance) and of volar plate prominence (Soong's grade, plate to critical line distance, and plate to volar rim distance).

Univariate analysis with Mann-Whitney U tests or chi-square tests was performed. Factors with a P-value > 0.2 by univariate analysis were introduced to multivariate logistic regression.

Results and Conclusions: In univariate analysis, body height (p=0.014) and plate prominence (Soong's grade 1, p=0.041) revealed statistically significant differences. In multivariate logistic regression, only the odds ratio (OR) for body height was statistically significant (OR = 1.32 per 1 cm less in body height, p=0.027). We created a receiver operating characteristic curve of FPL tendon rupture and body height, and established a cutoff value of 150 cm, calculated from the national statistical chart of body height of Japanese women (50-80 years old, average 154.36 cm, and the standard deviation of 2.23). As a result, the sensitivity was 75% and the specificity was 58% for using body height as a risk predictor for FPL tendon rupture.

In this study, volar plate prominence value of case group (FPL tendon rupture) were not so significantly different from those of control group. It is suggested that the risk of FPL tendon rupture after volar plate fixation is greater not only with plate prominence but also with physically smaller women in this case-control study.