# Closed Rupture of the Extensor Tendon of the Ring and Little Fingers Following Plate Fixation for Distal Ulna Fracture: A Case Report

## TL;DR

A rare case of extensor tendon rupture in the ring and little fingers occurred years after plate fixation for a distal ulna fracture, likely due to a prominent screw.

## Contribution

This case report highlights a rare complication of delayed extensor tendon rupture following distal ulna plate fixation.

## Key findings

- Computed tomography showed dorsal penetration of the most distal ulnar screw.
- Surgical exploration confirmed rupture of the extensor tendons to the ring and little fingers.
- Screw removal and tendon transfer led to satisfactory recovery without rerupture.

## Abstract

Extensor tendon rupture following plate fixation for distal ulna fractures is extremely rare. We present a case of delayed closed rupture of the extensor tendons of the ring and little fingers following distal ulna plate fixation. A 71-year-old woman developed progressive swelling and loss of active extension of the ring and little fingers eight years after surgery for distal radius and ulna fractures. Computed tomography demonstrated dorsal penetration of the most distal ulnar screw. Surgical exploration confirmed rupture of the extensor digitorum communis tendons to the ring and little fingers and the extensor digiti minimi tendon. Screw removal and end-to-side tendon transfer were performed, resulting in satisfactory functional recovery without rerupture. This case suggests that dorsal screw prominence in distal ulna plating may contribute to delayed attritional extensor tendon rupture. Surgeons should carefully assess screw length intraoperatively and consider early implant removal when tendon irritation is suspected.