The longest postoperative time of flexor pollicis longus tendon rupture, 15 years after volar locking plate fixation of a distal radius fracture: A case report

Introduction and importance: Flexor pollicis longus (FPL) tendon injury is a debilitating condition that rarely occurs after volar plate fixation; it can happen for various reasons, vary in severity, and affects hand function. The most common period of FPL tendon rupture after volar plate fixation for distal radius fractures is <2 years, and the longest reported period was about 10 years. Case presentation: A 66-year-old man attended our orthopedic clinic with a three-month history of pain and impaired flexion of the right interphalangeal joint of the thumb, with no known trauma or other history. According to his condition and documentation indicating a rupture of his FPL tendon in his right wrist, he underwent a tendon transfer. Clinical discussion: While multiple factors may contribute to rupture, plate positioning seems to be the most critical. However, no clear cause-effect relationship has been established. The risk of rupture after volar plate fixation may never be eliminated, and more extensive studies with larger populations are needed to draw definitive conclusions and potentially find preventive solutions. Conclusion: This study reports a case of FPL tendon rupture 15 years after volar plate fixation, the longest postoperative period recorded. While multiple factors may contribute to rupture, plate positioning seems to be the most critical. However, no clear cause-effect relationship has been established. The risk of rupture after volar plate fixation may never be eliminated, and more extensive studies with larger populations are needed to draw definitive conclusions and potentially find preventive solutions.