Rupture of muscle belly of the extensor carpi radialis longus

Abstract

A lo-year-old labourer sustained transverse fractures of the radius and ulna with dorsal angulation (Figure I). There were superficial lacerations on the dorsum of the wrist and surgical emphysema extended proximally to the elbow. There was no neurovascular deficit. Wound toilet, fasciotomy and internal fixation of the radius and ulna were carried out. Proximal extension of the surgical wounds allowed exploration of the emphysema. The muscle belly of the extensor carpi radialis longus was found to be ruptured proximally and could be delivered into the wound in two parts. It did not contract or bleed when cut after release of the tourniquet and the complete muscle belly (IOcm x 4an) was excised. Its tendon was sutured to the extensor carpi radialis brevis. Secondary suture of the wound with skin grafting was carried out 5 days later. The patient made an uncomplicated recovery. At 8 months after this accident he had resumed his normal job of labouring, involving heavy lifting and use of handheld tools. His only complaint was of occasional swelling of the forearm which was relieved by tubigrip support. There was no clinical deformity and the wounds were healed. Wrist extension was full and his grip was normally powerful. There was a loss of 20” supination and 10” wrist abduction. A radiograph showed that the fracture had healed (Figure 2).