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Rupture of the extensor pollicis longus tendon
E Bonatz1, T D Kramer, V R Masear
1Division of Orthopaedic Surgery, University of Alabama at Birmingham, USA.
American Journal of Orthopedics (Belle Mead, N.J.)
|February 1, 1996
Summary
Rupture of the extensor pollicis longus (EPL) tendon can occur after distal radius fractures or due to wrist tenosynovitis. Surgical repair using tendon grafts or transfers provides good functional outcomes for thumb extension.
Area of Science:
- Orthopedic Surgery
- Hand Surgery
- Musculoskeletal Research
Background:
- Rupture of the extensor pollicis longus (EPL) tendon is a recognized complication following distal radius fractures.
- EPL tendon rupture can also occur in patients without a history of fracture, potentially linked to chronic tenosynovitis.
Purpose of the Study:
- To analyze the outcomes of surgical interventions for extensor pollicis longus tendon rupture.
- To investigate the causes and treatment strategies for EPL tendon rupture in a cohort of patients.
Main Methods:
- Retrospective analysis of seven patients treated between 1985 and 1992 for EPL tendon rupture.
- Review of patient demographics, fracture types, associated conditions, surgical procedures, and follow-up outcomes.
Main Results:
- Five cases of EPL rupture were associated with nondisplaced Colles' fractures; two involved chronic tenosynovitis.
- Surgical reconstruction involved three extensor indicis proprius tendon transfers and four free palmaris longus tendon grafts.
- At follow-up, six patients achieved excellent or good results with minimal extensor lag or normal joint motion.
Conclusions:
- Extensor pollicis longus tendon rupture can result from mechanical irritation, attrition, or vascular compromise, sometimes secondary to synovitis.
- Surgical reconstruction using extensor indicis proprius transfer or palmaris longus tendon grafts is an effective treatment for EPL tendon rupture, restoring thumb function.