Abductor pollicis longus spontaneous rupture in the context of a non-displaced distal radius fracture: A case report

Abstract

Distal radius fractures are highly common both in the adult and pediatric population. Tendon injuries are included in the complications secondary to both conservative and surgically treated distal radius fractures. We present a rare case of a fifty one-year old female patient who suffered a non-displaced radial styloid fracture treated conservatively with a dorsal antebrachial splint for four weeks. After completing the immobilization period, she referred to a new localized radial wrist pain which affected her daily and laboral activities, remaining unresponsive to pain medication. Due to the pain and continuous need of a wrist splint, it was recommended the execution of a magnetic ressonance, which in turn diagnosed a midsubstance rupture of the abductor pollicis longus tendon. She was treated surgically with tendon reconstruction of the abductor pollicis longus with palmaris longus tendon free graft. She maintained the usage of a splint for three weeks postoperatively and subsequently began physical rehabilitation. At the final evaluation she had regained a full and painless range of motion of the injured wrist and thumb. Since there is no similar injury published in literature, we find important to share this case in order to one day establish the mechanism which injured the abductor pollicis longus.