Ankit Singh

Abstract

First extensor tendon compartment is composed of Extensor pollicis brevis (EPB) and Abductor pollicis longus (APL) and lack of knowledge of anatomical variation in conventional textbooks regarding these tendons lead to misdiagnosis of underlying condition.In our case, similar sized tendon slips of EPB with synovial sheath thickening was reported in Ultrasound (USG) as intra-substance tear and thus the inaccurate surgical plan was decided delaying the treatment and patient’s loss from work. Exploration of tendons lead to the findings of accessory slip of EPB and just pulley release of the same lead to faster restoration of daily activities without pain thus combating the surgical expense in resource deprived patient. Keywords: Abductor pollicis longus, Extensor pollicis brevis, Ultrasound

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Abstract

Introduction: Children and adolescents are prone to diaphyseal both bone forearm or radial shaft fractures. The use of ESIN (Elastic stable intramedullary nailing) for intramedullary fixation is recommended in such fractures with significant angulation/malrotation. Comparative study of complications resulted by the two most common entry points: Lister’s entry point and lateral entry was done. Materials and Methods: We report a prospective one-year comparative study of seventeen patients who were operated with ESIN (Lister’s entry/Lateral entry) and complications were ascertained of either entry points using CHOP parameters. Results: All seventeen patients underwent surgical intervention. Two out of eight cases with lister’s entry developed EI (Extensor indicis ) and EPL injury respectively whereas none of the patients with lateral entry showed any long term complications. No complications of infections, malunion or non-union was seen. Conclusion: We recommend using a lateral entry point based on our findings. Dorsal entry/Lister’s entry point complicating in extensor tendon injury often results in long-term complications prolonging period of rehabilitation.   Keywords: Both bone forearm fractures, ESIN, Lister’s tubercle, Lateral entry, Paediatric, Radial shaft fractures.

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