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Updated: Jul 8, 2026

Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
An Extensor Indicis Proprius Transfer for Chronic Extensor Pollicis Longus Injury After Nearly 2 Decades: A Case
Amir Ratna Shakya1, Prakrit Chhetri1, Nirab Kayastha1
1Department of Orthopedics, SBH, Kathmandu, Nepal.
Case:
A 36-year-old soldier presented for foreign training fitness with a history of a fall 18 years previously, that injured his nondominant left wrist. Initially, the injury was managed conservatively with a below elbow cast. Since then, he had been unable to extend the thumb at the interphalangeal joint but adapted well to daily activities. Surgical reconstruction using an extensor indicis proprius (EIP) to extensor pollicis longus (EPL) tendon transfer yielded favorable recovery.
Conclusion:
This case highlights neglected EPL injury over 18 years and confirms that EIP transfer, when precisely performed, can restore thumb function such as pinch and grip even in very delayed cases.
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