Retrograde elastic stable intramedullary nailing (ESIN) via a posterior approach to the radius as the principal cause of extensor pollicis longus tendon ruptures following pediatric forearm fractures

Forearm fractures are common pediatric injuries. Surgical intervention primarily comprises elastic stable intramedullary nailing (ESIN) or percutaneous K-wire osteosynthesis. Extensor pollicis longus (EPL) tendon rupture is a typical complication. Incidence ranges 0-16%, but sample sizes are critically low. Some questions are still not fully answered. Are EPL ruptures approach related? If so, are they procedure related and are there any references of intra- or postoperative tendon injury?

We analyzed postoperative course of children with forearm fractures treated at a level 1 trauma center between 04/2011 and 09/2021. All patients had postoperative follow-up and underwent implant removal at the same center. Data was collected from clinical information system and picture archiving and communication system. Data was collected by the corresponding authors as well as one of the co-authors.