Attritional rupture of the extensor pollicis longus tendon secondary to an osteochondroma of the distal radius

The extensor pollicis longus (EPL) tendon, given its complex anatomical course, is at a higher risk of rupture when compared with other extensor tendons of the hand. This is most often seen in the trauma setting, and up to 60% of cases are related to an underlying distal radius fracture. Spontaneous atraumatic ruptures are uncommon and often attributable to prolonged steroid use and tenosynovitis.Attritional ruptures from osseous lesions of the distal radius are not well described, and we are unaware of any cases related specifically to distal radius osteochondroma. This may be due to the rare nature of osteochondroma in this region and the fact that many cases are asymptomatic in the absence of complications. This case illustrates spontaneous EPL rupture secondary to an osteochondroma of Lister's tubercle and highlights that excision and tendon transfer can safely be completed in the same operative setting.