Causes and countermeasures for spontaneously ruptured extensor pollicis longus after non-operative treatment of distal radius fractures

Abstract:

Objective：To improve the diagnosis and treatment of spontaneously ruptured extensor pollicis longus（EPL） after non-oper－ative treatment of distal radius fractures. Methods：Causal analysis and standard operative treatment were conducted on 30 cases of spontaneously ruptured EPL with old distal radius fractures but without new wrist trauma. Results：Friction theory and Pressure theory would lead to EPL spontaneous rupture after distal radius fractures with or without displaced fracture. Once ruptured tendons were found，at early stage，the end to end in-situ remediation could be performed；at late stage，the reconstruction of EPL function by trans－ferring extensor indicis proprius（EIP） was more appropriate. Conclusion：Friction theory and Pressure theory need to be fully under－stood，and only the high risk factors for EPL spontaneous rupture were early found and properly treated，the lower incidence of EPL spontaneous rupture would become a reality.examinations during the same period were tested for their serum SOD activity，levels of urine iodine and IP-10，and other indices related to thyroid function. SOD activity，the levels of IP-10 and thyroid hormones，and the incidence of HT were compared between the subjects with different nutritional status. The correlation between iodine，SOD，and IP-10 was analyzed. Results：Compared with the control group，the elderly patients with HT had higher mean levels of urinary iodine（216.63 μg/L） and IP-10（194.41 ng/L），but lower SOD activity（92.99 U/mL）. The group with adequate iodine had significantly increased levels of thyroid stimulating hormone，free triiodothyronine，free thyroxine，and IP-10，but significantly decreased SOD activity. A correlation analysis showed that urinary iodine was negatively correlated with SOD activity and positively correlated with serum IP-10 level，and serum SOD activity was negatively correlated with the IP-10 level（r=0.662）. Conclusion：Excessive iodine intake is associated with HT in the elderly. High iodine level can affect the thyroid function，oxidative stress，and chemotactic factor level of patients.