Abstract：
We presumed that primary repair would be possible if the extensor pollicis longus (EPL) rupture after volar locking plating (VLP) for distal radius fracture (DRF) was diagnosed earlier. Thus, five cases of EPL ruptures were resolved via primary repair rather than extensor indicis proprius (EIP) transfer, so we reported the clinical outcomes of at least 2 years follow-up since EPL repair. Of 588 consecutive patients with the fractures treated between January 2016 and December 2019, 501 who met out inclusion/exclusion criteria were initially investigated. We informed patients of: (1) the ordinary range of motion of thumb at full wrist flexion/extension; (2) the proper tone of thumb extension compared to the contralateral thumb; and (3) the degree of pain/discomfort during thumb exercise. After discharge, we called each patient monthly commencing at 8 weeks postoperatively to enquire if any of those had worsened, by telephone. Five patients had ruptured EPLs diagnosed at a mean of postoperative-12.8 weeks. Three came to outpatient department for suspected tendon rupture just after telephone survey with the authors. The other two visited after detecting insufficiency in the three items, during the period between telephone inquiries. In four, the torn EPL were encapsulated by tendon sheathes. Extension lag at interphalangeal joint was absent and other clinical outcomes associated with DRF were all satisfactory at final follow-up. Primary repair of EPL rupture (rather than EIP transfer) is possible if patients are properly followed up after VLP for DRF. LEVEL OF EVIDENCE: Level IV, retrospective case series.
摘要：
我们认为，如果较早诊断出掌侧锁定钢板（VLP）治疗桡骨远端骨折（DRF）后的长伸肌（EPL）破裂，则可以进行初步修复。因此，5例EPL破裂是通过一期修复而不是固有伸肌（EIP）转移解决的，因此,我们报告了自EPL修复以来至少2年随访的临床结果.在2016年1月至2019年12月期间治疗的588例连续骨折患者中，有501例符合纳入/排除标准的患者进行了初步调查。我们告知患者：（1）拇指在全腕屈曲/伸展时的正常运动范围；（2）与对侧拇指相比，拇指伸展的适当音调；（3）拇指运动过程中的疼痛/不适程度。放电后,我们每月在术后8周开始给每位患者打电话，询问是否有任何恶化，通过电话。5例患者在平均术后12.8周时被诊断出破裂的EPL。在与作者进行电话调查后，三人因怀疑肌腱断裂而来到门诊。另外两个人在检测到这三个项目不足后访问，在电话查询期间。在四个,撕裂的EPL被肌腱鞘包裹。在最后的随访中，没有指间关节的延伸滞后，与DRF相关的其他临床结果均令人满意。如果在VLP后对患者进行DRF正确随访，则可以进行EPL破裂的主要修复（而不是EIP转移）。证据级别：四级，回顾性病例系列。
