Concomitant Rupture of the Tendons of Extensor Pollicis Longus and Extensor Indicis Proprius Following Volar Plating for a Distal Radius Fracture

We present a case of a patient who sustained a distal radius fracture and underwent volar plate fixation. Despite initial non-operative management, subsequent corrective osteotomy was required due to malunion. Eighteen months later, the patient presented with an inability to extend the thumb, leading to a diagnosis of extensor pollicis longus (EPL) tendon rupture. During the planned EPL tendon transfer procedure, an unexpected rupture of the extensor indicis proprius (EIP) tendon was discovered. The EIP tendon was then utilized as an interposition graft between the musculotendinous junction of the extensor indicis muscle and the EPL tendon to restore the function of EPL. This case highlights the potential for multiple tendon ruptures following distal radius fracture treatment, even in the absence of overt clinical signs. It emphasizes the importance of thorough preoperative assessment and intraoperative vigilance to identify and address such complications.