Traumatic rupture of the extensor pollicis longus tendon

Area of Science:

• Orthopedics
• Hand Surgery
• Traumatology

Background:

• Rupture of the extensor pollicis longus (EPL) tendon is a rare condition.
• Commonly associated with rheumatoid arthritis or Colles' fracture, accounting for approximately 50% of cases.
• Other causes include direct closed or hyperextension wrist injuries, with rotational injuries being less common.

Observation:

• Delayed rupture may result from avascular necrosis due to disruption of the mesotendon.
• Rotational injuries can lead to complete avulsion of the EPL tendon at the musculotendinous junction.
• Surgical intervention is the primary treatment modality.

Findings:

• Tendon transfer using the extensor indicis proprius is the preferred surgical method.
• Postoperative management requires immobilization, thumb hyperextension, and adequate resting tension for optimal functional recovery.
• Patients may experience a slight decrease in index finger extensor strength and potentially a minimal loss in extensor range of motion.

Implications:

• Successful surgical correction can restore thumb extensor function.
• Careful postoperative care is crucial for achieving good functional outcomes.
• Potential for minor, long-term functional deficits in the index finger should be considered.