Tendon transfer for rupture of the extensor pollicis longus

Area of Science:

• Orthopedic surgery
• Hand surgery
• Tendon pathology

Background:

• Extensor pollicis longus (EPL) tendon rupture is a known complication.
• The etiology involves vascular compromise leading to ischemic necrosis and attrition.
• Previous treatments include direct repair, grafting, and transfer.

Purpose of the Study:

• To review the history and etiology of EPL tendon rupture.
• To evaluate treatment options for EPL tendon rupture.
• To recommend the most predictable surgical technique for EPL reconstruction.

Main Methods:

• Literature review of EPL tendon rupture history and etiology.
• Analysis of historical and current treatment modalities.
• Evaluation of tendon transfer techniques, specifically extensor indicis proprius (EIP) transfer.

Main Results:

• Vascular interruption secondary to hemorrhage and pressure is the primary mechanism of EPL rupture.
• EIP tendon transfer demonstrates predictability in restoring EPL function.
• EIP transfer is associated with reliable execution, minimal postoperative rehabilitation, and low complication rates.

Conclusions:

• The extensor indicis proprius tendon transfer is the preferred method for EPL tendon rupture.
• This technique offers reliable functional recovery and a favorable safety profile.
• Understanding the etiology is crucial for effective treatment selection.