A Retrospective Cohort Study of Extensor Pollicis Longus Reconstruction Using Palmaris Longus Tendon Graft or...

Area of Science:

• Orthopedic surgery
• Hand surgery
• Reconstructive surgery

Background:

• Extensor pollicis longus (EPL) rupture management options include palmaris longus (PL) tendon graft reconstruction and extensor indicis proprius (EIP) transfer.
• Limited comparative data exist for functional outcomes and delayed reconstruction between these EPL rupture surgical techniques.

Purpose of the Study:

• To evaluate and compare functional outcomes and complications of EPL reconstruction using PL grafts versus EIP transfer.
• To assess the efficacy of delayed PL graft reconstruction for EPL rupture.

Main Methods:

• Retrospective cohort study of 38 patients with EPL rupture (2004-2020).
• Data collected on demographics, surgical procedures, and outcomes (DASH scores).
• Statistical analysis included Fisher exact test, chi-squared test, and t-test (P < .05 significance).

Main Results:

• Both PL graft (n=8) and EIP transfer (n=30) groups showed improved DASH scores post-surgery.
• The PL graft group demonstrated a larger mean reduction in DASH scores.
• Three patients (11%) in the EIP transfer group experienced extensor lag; none in the PL graft group.

Conclusions:

• Both PL graft reconstruction and EIP transfer lead to postoperative functional improvement for EPL rupture.
• While PL grafts showed greater DASH score improvement, baseline differences limit direct comparison.
• Delayed PL graft reconstruction yielded acceptable outcomes in this cohort.