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The Extensor Indicis Proprius Transposition for the Ulnar Collateral Ligament Stabilization in Thumb Hypoplasia

Dzintars Ozols1,2,3, Rudolfs Laucis1, Reinis Osins1

  • 1Department of Paediatric Surgery, Riga Stradins University.

Techniques in Hand & Upper Extremity Surgery
|October 4, 2022
PubMed

Insights

Extensor indicis proprius (EIP) tendon transposition offers a promising surgical solution for thumb hypoplasia, improving both hand function and appearance in young patients. This technique stabilizes the first metacarpophalangeal joint, aiding in normal development.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Hand Surgery
  • Congenital Hand Deformities

Background:

  • Congenital upper extremity deformities affect 0.15-0.2% of newborns.
  • Thumb functionality is crucial for hand performance and psychoemotional development.
  • Existing surgical options for thumb hypoplasia include flexor tendon transposition, but EIP tendon use is less studied.

Purpose of the Study:

  • To evaluate the efficacy of extensor indicis proprius (EIP) tendon transposition for stabilizing the ulnar collateral ligament in thumb hypoplasia.
  • To assess the functional and esthetic outcomes of this surgical technique in pediatric patients.

Main Methods:

  • EIP tendon transposition with subperiosteal fixation was performed on 14 patients with thumb hypoplasia (grades II-IIIb).
  • Mean patient age was 38 months (range: 11-128 months).
  • Long-term follow-up (2-10 years) assessed esthetic and functional results.

Main Results:

  • All patients (n=14) with thumb hypoplasia grades II-IIIb showed satisfactory functional and esthetic outcomes post-surgery.
  • The EIP transposition technique effectively stabilized the ulnar collateral ligament for the first metacarpophalangeal joint.
  • No major complications were reported during the long-term follow-up period.

Conclusions:

  • EIP tendon transposition is a viable and effective surgical alternative for reconstructing thumb hypoplasia, particularly for grades II-IIIa.
  • The procedure leads to significant improvements in both hand function and cosmetic appearance.
  • This technique addresses a gap in the literature regarding EIP tendon utilization for thumb hypoplasia reconstruction.

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