Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jul 15;14(7):e242509.
doi: 10.1136/bcr-2021-242509.

Supernumerary extensor pollicis longus tendon masking an extensor pollicis longus rupture following non-surgical treatment of a distal radius fracture

Bradley D Wiekrykas  1 , Mark K Solarz  1 , Hesham M Abdelfattah  2 , Joseph J Thoder  1
Affiliations
Case Reports

Supernumerary extensor pollicis longus tendon masking an extensor pollicis longus rupture following non-surgical treatment of a distal radius fracture

Bradley D Wiekrykas et al. BMJ Case Rep. .

Abstract

Extensor pollicis longus tendon pathology is a recognised complication following non-surgical treatment of non-displaced distal radius fractures. Tendon entrapment typically presents with pain, but preservation of thumb retropulsion during complete rupture results in loss of active thumb retropulsion and tenodesis effect. We present the case of a 52-year-old woman who developed extensor pollicis longus tendon entrapment with full active thumb extension following a non-displaced distal radius fracture. During her elective third dorsal compartment release, the extensor pollicis longus tendon was found to be completely ruptured and a rare supernumerary extensor pollicis longus tendon was found emerging from the fourth dorsal compartment. Gentle traction of this tendon resulted in thumb interphalangeal joint extension and simultaneous index finger metacarpophalangeal joint extension. An extensor indicis proprius to extensor pollicis longus tendon transfer was performed. At her final 6-month follow-up, she had painless full active thumb motion comparable to her contralateral side.

Keywords: orthopaedic and trauma surgery; orthopaedics; tendon rupture.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A, B) Initial anteroposterior and lateral radiographs of the left wrist.
Figure 2
Figure 2
(A, B) Seven-week anteroposterior and lateral radiographs of the left wrist.
Figure 3
Figure 3
(A) Supernumerary extensor pollicis longus tendon and (B) ruptured distal end of the extensor pollicis longus tendon.
Figure 4
Figure 4
(A–C) : (A) resting thumb position, (B) extensor pollicis longus tendon traction demonstrating thumb retropulsion (C) supernumerary extensor pollicis longus tendon traction demonstrating thumb retropulsion and index metacarpalphalangeal joint extension
See this image and copyright information in PMC

References

    1. McKay SD, MacDermid JC, Roth JH, et al. . Assessment of complications of distal radius fractures and development of a complication checklist. J Hand Surg Am 2001;26:916–22. 10.1053/jhsu.2001.26662 - DOI - PubMed
    1. Roth KM, Blazar PE, Earp BE, et al. . Incidence of extensor pollicis longus tendon rupture after nondisplaced distal radius fractures. J Hand Surg Am 2012;37:942–7. 10.1016/j.jhsa.2012.02.006 - DOI - PubMed
    1. Helal B, Chen SC, Iwegbu G. Rupture of the extensor pollicis longus tendon in undisplaced Colles’ type of fracture. Hand 1982;os-14:41–7. 10.1016/S0072-968X(82)80038-7 - DOI - PubMed
    1. Skoff HD. Postfracture extensor pollicis longus Tenosynovitis and tendon rupture: a scientific study and personal series. Am J Orthop 2003;32:245–7. - PubMed
    1. Engkvist O, Lundborg G. Rupture of the extensor pollicis longus tendon after fracture of the lower end of the radius--a clinical and microangiographic study. Hand 1979;11:76–86. 10.1016/s0072-968x(79)80015-7 - DOI - PubMed

Publication types

LinkOut - more resources