Flexor pollicis longus tendon rupture after volar wrist plating : reconstruction with palmaris longus interposition graft

Rupture of the flexor pollicis longus tendon is a rare complication after volar plating of distal radius fractures. Several surgical treatment options have been proposed but postoperative results are not well documented. The authors retrospectively studied the clinical outcome of 4 patients after flexor pollicis longus tendon reconstruction with a palmaris longus interposition graft. Minimal follow-up was 12 months. Mean active interphalangeal joint flexion (44 degrees) and thumb opposition (Kapandji 8/10) were significantly reduced compared to the opposite side. Mean power grip (32 kg) and key pinch strength (8kg) of the operated hand were comparable to the contralateral hand. The mean Visual Analogue Scale for pain was 2.5/10. The mean DASH score was 14 points. Although flexion and opposition of the thumb did not return to normal after surgery, patients reported excellent functional results.