Tendon transfer for rupture of the extensor pollicis longus

Reviewing the history and etiology of extensor pollicis longus tendon rupture shows the most compelling mechanism of rupture apparently is interruption of the tendon's vascularity secondary to hemorrhage and pressure, which causes the damaged tendon to be more susceptible to rupture secondary to late ischemic necrosis and attrition. Treatment options tried have included direct repair, tendon grafting, and tendon transfer. The authors recommend the extensor indicis proprius tendon transfer as the most predictable procedure to restore the original function of the EPL. This technique can be performed reliably, requires little postoperative re-education, and has few associated complications.