Introduction:
Rupture of the flexor pollicis longus tendon is a rare complication after volar plating of distal radius fractures. Several surgical treatment options have been proposed but postoperative results are not well documented. There are some retrospectively studied published after flexor pollicis longus tendon reconstruction with a palmaris longus interposition graft. Primary repair of chronic FPL tendon ruptures is difficult due to tendon rupture. Treatment options are interposition tendon graft, tendon transfer, tendon advancement. The purpose of this study was to propose our experience of a case as well as surgical incidence and complication of internal fixation for distal radius fracture.

Material and Methods:
A 68-year-old female suffered distal radius fracture over left wrist after falling downstairs accidentally. Open reduction and internal fixation with volar locking plate was performed then. She had visited outpatient clinic following after discharged from hospital for six months. Function of hand had returned within normal limit from then on. Without radiographic evidence of fracture for nonunion nor collapse of the distal fragment founded until incapable of flexion over her left thumb one and half year later from last orthopedic surgery. Physical examination revealed preserved extension function ranging from left thumb to little finger. Tendon impairment of left flexor pollicis longus was impressed. Surgical technique of pulvertaft weave for flexor pollicis longus tendon graft reconstruction with palmaris longus tendon performed during this treatment.

Results:
Plate and screw osteosynthesis on the volar side of the distal radius can interfere with flexor tendon function. Hardware that is placed prominent to the watershed line can irritate the flexor tendons. Flexor tenosynovitis can be followed by tendon rupture and is an indication for hardware removal. Of all the flexor tendons the FPL tendon is most prone to rupture, followed by the FDS tendon to the index finger

Conclusion:
FPL reconstruction with PL autograft is a valuable treatment option that can provide good functional recovery of hand function provided that the FPL-tendon has an excursion of at least 2cm.