The intercalated tendon graft for treatment of extensor pollicis longus tendon rupture

Twenty-one patients with ruptures of the extensor pollicis longus tendon were treated with a subcutaneously placed free tendon graft. The repair was performed a mean of 6 weeks after rupture, range from 1 to 21 weeks. Data was collected on 19 of these patients, with a mean follow-up of 30 months, range from 6 to 124 months. Near uniform satisfaction was reported. The mean loss of interphalangeal joint extension and flexion and combined metacarpophalangeal-interphalangeal joint motion was 6 degrees, 3 degrees, and 10 degrees, respectively. The mean loss of pinch strength was 7%. All patients were able to elevate their thumbs to the level of the palm. This is a simple, reliable, and effective procedure that avoids the use of an adjacent motor-tendon unit. Muscle contracture appears reversible and this procedure may be used successfully even when treatment has been delayed.