Four cases of flexor tendon problems which developed after volar plate fixation of distal radius fractures are presented. All cases were associated with close contact of the screws or distal edge of the plate with the flexor tendons. Poor bone stock or multiple bone fragments allowing loosening of the plate or non-locking screws cause the hardware to irritate the flexor tendons and ultimately lead to rupture. The flexor tendons involved include the flexor carpi radialis, flexor pollicis longus and flexor digitorum superficialis, and flexor digitorum profundus to the index and long fingers.
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