From the Research
During a dorsal plating procedure for a distal radius fracture, the extensor pollicis longus tendon is at high risk of damage due to its superficial location on the dorsal aspect of the wrist, as well as the sensory branch of the radial nerve, dorsal radiocarpal ligaments, and the dorsal cortex of the radius itself. The potential for iatrogenic injury to these structures is significant, and careful consideration must be given to surgical technique to minimize these risks. Some of the key structures that can be damaged include:
- Extensor tendons, particularly the extensor pollicis longus tendon, which can be irritated by hardware or directly injured during dissection 1
- Sensory branch of the radial nerve, which can lead to painful neuroma formation or sensory deficits if damaged
- Dorsal radiocarpal ligaments, which may be damaged during exposure of the fracture site, potentially contributing to postoperative instability
- Dorsal cortex of the radius, which can be compromised during plate application, and excessive soft tissue stripping, which may disrupt the blood supply to fracture fragments, potentially leading to delayed union or nonunion 2. It is essential to be aware of these potential complications and take steps to mitigate them, such as using careful surgical technique and considering alternative approaches, like volar plating, when possible 3, 4, 5.