Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation

Aim of the study: To assess the features identified on ultrasound in patients presenting with suspected extensor pollicis longus tendon rupture, and correlate this with surgical findings. Material and methods: A retrospective case series review was performed in 11 patients (8 female, 3 male) with su...

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Main Authors: Ghazal Louy, Nabi Mohammed, Little Christopher, Teh James
Format: Article
Language:English
Published: Sciendo 2020-01-01
Series:Journal of Ultrasonography
Subjects:
Online Access:https://doi.org/10.15557/jou.2020.0001
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author Ghazal Louy
Nabi Mohammed
Little Christopher
Teh James
author_facet Ghazal Louy
Nabi Mohammed
Little Christopher
Teh James
author_sort Ghazal Louy
collection DOAJ
description Aim of the study: To assess the features identified on ultrasound in patients presenting with suspected extensor pollicis longus tendon rupture, and correlate this with surgical findings. Material and methods: A retrospective case series review was performed in 11 patients (8 female, 3 male) with suspected extensor pollicis longus tendon rupture. All ultrasound examinations were performed by an experienced musculoskeletal radiologist using a high-resolution linear-array probe. The study evaluated the associated sonographic appearances of extensor pollicis longus tendon rupture and correlated with surgical findings. Results: Rupture of the extensor pollicis longus tendon was identified in all cases proximally at the level of Lister’s tubercle. The most common associated sonographic finding was an effusion in the sheath of compartment III (10 patients); 9 patients also had fluid within the sheath of compartment II. An empty tendon sheath was observed in 1 patient and tenosynovitis of the extensor pollicis longus sheath was demonstrated in 2 cases. In 9 patients, sonography revealed the retracted tendon ends as enlarged and hypoechoic with loss of their normal fibrillar appearance. Ultrasound depicted fracture involvement of Lister’s tubercle in 8 cases (compared to 4 cases identified radiographically). In the 8 cases that proceeded to operative intervention, all of these were confirmed as extensor pollicis longus tendon rupture. Conclusion: Ultrasound is a valuable tool in identifying patients with extensor pollicis longus tendon rupture, providing the surgeon with invaluable details with regard to the level of rupture to aid pre-operative planning. US identifies associated ancillary features of extensor pollicis longus tendon rupture and reliably detects fractures involving Lister’s tubercle.
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spelling doaj.art-2cb8fc4fa74c4567a50587fdda5035942022-12-22T00:59:28ZengSciendoJournal of Ultrasonography2451-070X2020-01-0120801510.15557/jou.2020.0001Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlationGhazal Louy0Nabi Mohammed1Little Christopher2Teh James3Department of Radiology, Nuffield Orthopaedic Centre, Oxford, UKDepartment of Radiology, Nuffield Orthopaedic Centre, Oxford, UKDepartment of Radiology, Nuffield Orthopaedic Centre, Oxford, UKDepartment of Radiology, Nuffield Orthopaedic Centre, Oxford, UKAim of the study: To assess the features identified on ultrasound in patients presenting with suspected extensor pollicis longus tendon rupture, and correlate this with surgical findings. Material and methods: A retrospective case series review was performed in 11 patients (8 female, 3 male) with suspected extensor pollicis longus tendon rupture. All ultrasound examinations were performed by an experienced musculoskeletal radiologist using a high-resolution linear-array probe. The study evaluated the associated sonographic appearances of extensor pollicis longus tendon rupture and correlated with surgical findings. Results: Rupture of the extensor pollicis longus tendon was identified in all cases proximally at the level of Lister’s tubercle. The most common associated sonographic finding was an effusion in the sheath of compartment III (10 patients); 9 patients also had fluid within the sheath of compartment II. An empty tendon sheath was observed in 1 patient and tenosynovitis of the extensor pollicis longus sheath was demonstrated in 2 cases. In 9 patients, sonography revealed the retracted tendon ends as enlarged and hypoechoic with loss of their normal fibrillar appearance. Ultrasound depicted fracture involvement of Lister’s tubercle in 8 cases (compared to 4 cases identified radiographically). In the 8 cases that proceeded to operative intervention, all of these were confirmed as extensor pollicis longus tendon rupture. Conclusion: Ultrasound is a valuable tool in identifying patients with extensor pollicis longus tendon rupture, providing the surgeon with invaluable details with regard to the level of rupture to aid pre-operative planning. US identifies associated ancillary features of extensor pollicis longus tendon rupture and reliably detects fractures involving Lister’s tubercle.https://doi.org/10.15557/jou.2020.0001ultrasoundextensor pollicis longustendonruptureradius fractures
spellingShingle Ghazal Louy
Nabi Mohammed
Little Christopher
Teh James
Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation
Journal of Ultrasonography
ultrasound
extensor pollicis longus
tendon
rupture
radius fractures
title Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation
title_full Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation
title_fullStr Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation
title_full_unstemmed Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation
title_short Ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture: a sonographic and surgical correlation
title_sort ultrasound assessment of extensor pollicis longus tendon rupture following distal radius fracture a sonographic and surgical correlation
topic ultrasound
extensor pollicis longus
tendon
rupture
radius fractures
url https://doi.org/10.15557/jou.2020.0001
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AT nabimohammed ultrasoundassessmentofextensorpollicislongustendonrupturefollowingdistalradiusfractureasonographicandsurgicalcorrelation
AT littlechristopher ultrasoundassessmentofextensorpollicislongustendonrupturefollowingdistalradiusfractureasonographicandsurgicalcorrelation
AT tehjames ultrasoundassessmentofextensorpollicislongustendonrupturefollowingdistalradiusfractureasonographicandsurgicalcorrelation