Spontaneous Extensor Pollicis Longus Rupture Following Pediatric Distal Radius Fracture: A Case Report

Two patients, a 14-year-old female and a 15-year-old male, presented with fractures of the right distal radius. The first patient had a non-displaced buckle fracture and recovered fully after six weeks in a short arm cast; however, ten weeks after the initial injury, she presented with a sudden inability to extend the right thumb with no inciting event. The second patient had a displaced fracture, requiring two closed reductions and a percutaneous pinning procedure. The patient fully recovered after about two months; however, he presented eight months after the initial injury, reporting sudden pain in his right dorsal wrist and thumb while wrestling and inability to extend his thumb since. Both patients were diagnosed with extensor pollicis longus (EPL) tendon rupture and underwent extensor indicis proprius (EIP) to EPL tendon transfer. These cases demonstrate that EPL tendon rupture can occur after distal radius fractures in pediatric patients, and providers must be aware of this complication to intervene early.