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Published in: Surgical and Radiologic Anatomy 7/2019

01-07-2019 | Distal Radius Fracture | Original Article

Anatomical–positional relationship between the bone structure of the distal radius and flexor pollicis longus tendon using ultrasonography

Authors: Mayuko Kinoshita, Kiyohito Naito, Kenji Goto, Yoichi Sugiyama, Nana Nagura, Hiroyuki Obata, Yoshiyuki Iwase, Kazuo Kaneko

Published in: Surgical and Radiologic Anatomy | Issue 7/2019

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Abstract

Purpose

In this study, using an ultrasonography, we investigated the positional relationship between the volar bone cortex of distal radius and flexor pollicis longus (FPL) tendon in the distal radius of healthy subjects.

Methods

The subjects were 32 healthy volunteers (56 wrists) (Age 32.9 ± 8.5, 16 males and 16 females). Their wrists were imaged by an ultrasonography. The distances between the watershed line (WS) and FPL (A), between the distal margin of pronator quadratus (DMPQ) and FPL (B), between the FPL and volar radial bone cortex at the maximum muscle belly of the PQ muscle right below the sliding region of the FPL tendon (C), and between the WS and DMPQ (D) were measured.

Results

All these parameters showed a normal distribution. When the correlation among the parameters was investigated, a correlation with an index of the physique, BMI, was noted in A (P < 0.01), B (P < 0.01), and C (P < 0.01), but no correlation was noted only in D (P = 0.59).

Conclusions

Our results were suggested that when distal radius fracture is treated with a distal plate placement, the appropriate placement can be achieved by applying about 3 mm additional dissection of soft tissue on the volar bone cortex distal to the DMPQ.
Literature
1.
go back to reference Asadollahi S, Keith PP (2013) Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature. J Orthop Traumatol 14:227–234CrossRef Asadollahi S, Keith PP (2013) Flexor tendon injuries following plate fixation of distal radius fractures: a systematic review of the literature. J Orthop Traumatol 14:227–234CrossRef
2.
go back to reference Cross AW, Schmidt CC (2008) Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg Am 33:164–167CrossRef Cross AW, Schmidt CC (2008) Flexor tendon injuries following locked volar plating of distal radius fractures. J Hand Surg Am 33:164–167CrossRef
3.
go back to reference Goorens CK, Van Royen K, Grijseels S, Provyn S, De Mey J, Scheerlinck T, Goubau JF (2018) Ultrasonographic evaluation of the distance between the flexor pollicis longus tendon and volar prominence of the plate as a function of volar plate positioning and pronator quadratus repair—a cadaver study. Hand Surg Rehabil 37:171–174CrossRef Goorens CK, Van Royen K, Grijseels S, Provyn S, De Mey J, Scheerlinck T, Goubau JF (2018) Ultrasonographic evaluation of the distance between the flexor pollicis longus tendon and volar prominence of the plate as a function of volar plate positioning and pronator quadratus repair—a cadaver study. Hand Surg Rehabil 37:171–174CrossRef
4.
go back to reference Imatani J, Akita K, Yamaguchi K, Shimizu H, Kondou H, Ozaki T (2012) An anatomical study of the watershed line on the volar, distal aspect of the radius: implications for plate placement and avoidance of tendon ruptures. J Hand Surg Am 37:1550–1554CrossRef Imatani J, Akita K, Yamaguchi K, Shimizu H, Kondou H, Ozaki T (2012) An anatomical study of the watershed line on the volar, distal aspect of the radius: implications for plate placement and avoidance of tendon ruptures. J Hand Surg Am 37:1550–1554CrossRef
5.
go back to reference Kadoma C, Takahara M, Maruyama M, Satake H, Takagi M (2017) Ultrasonographic assessment of the flexor pollicis longus tendon after plate fixation. Orthopedics 40:e104–e108CrossRef Kadoma C, Takahara M, Maruyama M, Satake H, Takagi M (2017) Ultrasonographic assessment of the flexor pollicis longus tendon after plate fixation. Orthopedics 40:e104–e108CrossRef
6.
go back to reference Kwon BC, Lee JK, Lee SY, Hwang JY, Seo JH (2018) Morphometric variations in the volar aspect of the distal radius. Clin Orthop Surg 10:462–467CrossRef Kwon BC, Lee JK, Lee SY, Hwang JY, Seo JH (2018) Morphometric variations in the volar aspect of the distal radius. Clin Orthop Surg 10:462–467CrossRef
7.
go back to reference Limthongthang R, Bachoura A, Jacoby SM, Osterman AL (2014) Distal radius volar locking plate design and associated vulnerability of the flexor pollicis longus. J Hand Surg Am 39:852–860CrossRef Limthongthang R, Bachoura A, Jacoby SM, Osterman AL (2014) Distal radius volar locking plate design and associated vulnerability of the flexor pollicis longus. J Hand Surg Am 39:852–860CrossRef
8.
go back to reference Nanno M, Kodera N, Tomori Y, Takai S (2016) Transverse ultrasound assessment of the flexor pollicis longus tendon movement on the distal radius during wrist and finger motion in distal radius fracture with volar plating. J Med Ultrason (2001) 43:29–36CrossRef Nanno M, Kodera N, Tomori Y, Takai S (2016) Transverse ultrasound assessment of the flexor pollicis longus tendon movement on the distal radius during wrist and finger motion in distal radius fracture with volar plating. J Med Ultrason (2001) 43:29–36CrossRef
9.
go back to reference Nanno M, Kodera N, Tomori Y, Takai S (2018) Ultrasonographic movement of the flexor pollicis longus tendon before and after removal of a volar plate for the distal radius fracture. J Orthop Surg 26:2309499018760131 Nanno M, Kodera N, Tomori Y, Takai S (2018) Ultrasonographic movement of the flexor pollicis longus tendon before and after removal of a volar plate for the distal radius fracture. J Orthop Surg 26:2309499018760131
10.
go back to reference Orbay JL, Touhami A (2006) Current concepts in volar fixed-angle fixation of unstable distal radius fractures. Clin Orthop Relat Res Apr 445:58–67CrossRef Orbay JL, Touhami A (2006) Current concepts in volar fixed-angle fixation of unstable distal radius fractures. Clin Orthop Relat Res Apr 445:58–67CrossRef
11.
go back to reference Soong M, van Leerdam R, Guitton TG, Got C, Katarincic J, Ring D (2011) Fracture of the distal radius: risk factors for complications after locked volar plate fixation. J Hand Surg Am 36:3–9CrossRef Soong M, van Leerdam R, Guitton TG, Got C, Katarincic J, Ring D (2011) Fracture of the distal radius: risk factors for complications after locked volar plate fixation. J Hand Surg Am 36:3–9CrossRef
12.
go back to reference Tanaka Y, Aoki M, Izumi T, Fujimiya M, Yamashita T, Imai T (2011) Effect of distal radius volar plate position on contact pressure between the flexor pollicis longus tendon and the distal plate edge. J Hand Surg Am 36:1790–1797CrossRef Tanaka Y, Aoki M, Izumi T, Fujimiya M, Yamashita T, Imai T (2011) Effect of distal radius volar plate position on contact pressure between the flexor pollicis longus tendon and the distal plate edge. J Hand Surg Am 36:1790–1797CrossRef
13.
go back to reference Tanaka Y, Gotani H, Yano K, Sasaki K, Hamada Y (2017) Evaluation of flexor pollicis longus tendon attrition using color Doppler imaging after volar plate fixation for distal radius fracture. J Orthop Sci 22:447–452CrossRef Tanaka Y, Gotani H, Yano K, Sasaki K, Hamada Y (2017) Evaluation of flexor pollicis longus tendon attrition using color Doppler imaging after volar plate fixation for distal radius fracture. J Orthop Sci 22:447–452CrossRef
14.
go back to reference Vosbikian MM, Ketonis C, Huang R, Ilyas AM (2016) Optimal positioning for volar plate fixation of a distal radius fracture: determining the distal dorsal cortical distance. Orthop Clin N Am 47:235–244CrossRef Vosbikian MM, Ketonis C, Huang R, Ilyas AM (2016) Optimal positioning for volar plate fixation of a distal radius fracture: determining the distal dorsal cortical distance. Orthop Clin N Am 47:235–244CrossRef
15.
go back to reference Yamazaki H, Uchiyama S, Komatsu M, Hashimoto S, Kato H (2015) Risk assessment of tendon attrition following treatment of distal radius fractures with volar locking plates using audible crepitus and placement of the plate: a prospective clinical cohort study. J Hand Surg Am 40:157–181CrossRef Yamazaki H, Uchiyama S, Komatsu M, Hashimoto S, Kato H (2015) Risk assessment of tendon attrition following treatment of distal radius fractures with volar locking plates using audible crepitus and placement of the plate: a prospective clinical cohort study. J Hand Surg Am 40:157–181CrossRef
Metadata
Title
Anatomical–positional relationship between the bone structure of the distal radius and flexor pollicis longus tendon using ultrasonography
Authors
Mayuko Kinoshita
Kiyohito Naito
Kenji Goto
Yoichi Sugiyama
Nana Nagura
Hiroyuki Obata
Yoshiyuki Iwase
Kazuo Kaneko
Publication date
01-07-2019
Publisher
Springer Paris
Published in
Surgical and Radiologic Anatomy / Issue 7/2019
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI
https://doi.org/10.1007/s00276-019-02216-9

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