scholarly journals A Simple and Quick Tendon Transfer Technique to Restore Thumb Extension.

2020 ◽  
pp. 1-3
Keyword(s):  
Local Anaesthesia ◽  
Regional Anaesthesia ◽  
Tendon Transfer ◽  
Extensor Tendon ◽  
Extensor Pollicis Longus ◽  
Tendon Reconstruction ◽  
Good Outcome ◽  
Extensor Indicis Proprius ◽  
Direct Repair ◽  
Closed Rupture

Abstract Extensor pollicis longus (EPL), the long extensor tendon for the thumb, is one of the commonest tendon to rupture and require treatment. In case of closed rupture of EPL, direct repair is usually not possible, requiring tendon reconstruction to restore function. Traditionally, extensor indicis proprius (EIP) tendon is transferred under general or regional anaesthesia through two (or more) incisions. The author proposes and demonstrates that it is possible to carry out this transfer through one short incision under local anaesthesia with good outcome and minimal complications.

scholarly journals Delayed presentation of extensor pollicis longus tendon injury treated using extensor indicis proprius tendon transfer

2019 ◽  
Vol 6 (11) ◽  
pp. 4138
Author(s):  
Nilesh B. Ghelani ◽  
Sankit Shah ◽  
Sunmathi B. P. ◽  
Samir Patel
Keyword(s):  
Tendon Transfer ◽  
Index Finger ◽  
Safe Procedure ◽  
Delayed Presentation ◽  
Extensor Pollicis Longus ◽  
Extensor Indicis Proprius ◽  
Closed Rupture ◽  
Flexion Extension ◽  
The Mean

Spontaneous closed rupture of EPL tendon are frequently associated with rheumatoid arthritis, Colles fracture, sports related injury. In cases of delayed presentation direct tendon repair is not feasible and a tendon transfer is usually recommended. In this study we evaluated the results of extensor indicis proprius (EIP) to extensor pollicis longus (EPL) transfers for EPL ruptures. Four patients, (two male and two females); mean age 32 years (range 20 to 45 years) with EPL tendon rupture underwent EIP to EPL tendon transfer. The mean duration from rupture to surgery was 4.5 weeks (range 4 to 6 weeks). Range of motion of the metacarpophalangeal (MCP), interphalangeal joints (IP) of the thumb and index finger of the operated side was compared with the normal side. The results were scored using geldmacher scheme, for the thumb four functions were scored, the radial abduction angle, the elevation deficit, the opposition distance and flexion extension deficit of MP and IP joints. The mean follow-up period was 5 months. All the four patients were able extend the thumb at MCP joint and oppose the thumb to the MCP of little finger after mean follow up of 5 months. Based on the questionnaire, the results of tendon transfer scored by three (75%) patients was excellent and by one (25%) patient was good. Independent extension of the index finger of operated hand was possible in all 4 patients. The procedure of EIP to EPL tendon transfer provides excellent result for extension of thumb. It is a safe procedure.

scholarly journals Bridge Plate Failure with Extensor Tendon Injury: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Rachel Lefebvre ◽  
Jessica Intravia ◽  
Lisa Cao ◽  
Alidad Ghiassi ◽  
Milan Stevanovic
Keyword(s):  
Case Report ◽  
Tendon Transfer ◽  
Plate Fixation ◽  
Extensor Tendon ◽  
Tendon Injury ◽  
Extensor Pollicis Longus ◽  
Bridge Plate ◽  
Important Relationship ◽  
Extensor Carpi Radialis ◽  
Plate Failure

Background. Dorsal spanning plate fixation is an increasingly popular method of fixation for certain distal radius fractures. Published outcomes are encouraging, but complications are still reported. Methods. We present a case report of a 26-year-old woman with spanning plate breakage and extensor pollicis longus (EPL) metallosis, fraying, and near-complete rupture. The patient’s unsuccessful follow-up led to this complication. Metallosis and damage to the extensor indices (EI) and distal extensor carpi radialis longus (ECRL) were intraoperative obstacles for tendon transfer to restore EPL function. Results. Tendon transfer in the setting of bridge plate failure has not yet been described in the literature. There are reports of spanning plate failure indicating that breakage often happens through the plate’s holes and after fracture healing. Conclusions. The compounded complication of plate failure with extensor tendon injury emphasizes the important relationship between the local anatomy, barriers to patient care, and potential problems after spanning plate fixation.

scholarly journals Evaluation of Extensor Pollicis Brevis as a Recipient of Tendon Transfer for Thumb Extension

2019 ◽  
Vol 52 (02) ◽  
pp. 171-177 ◽  
Author(s):  
Praveen Bhardwaj ◽  
Poonacha Puchimada Muddappa ◽  
Dadi Bindesh ◽  
Shanmuganathan Raja Sabapathy
Keyword(s):  
Tendon Transfer ◽  
Anatomical Variation ◽  
Excellent Result ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Radial Nerve Palsy ◽  
Brachial Plexus Palsy ◽  
Extensor Pollicis Longus ◽  
Extensor Pollicis Brevis ◽  
Flexor Carpi Ulnaris

Abstract Introduction Rerouting of the extensor pollicis longus (EPL) is the standard part of tendon transfer surgery for thumb extension. It is done to overcome the ulnar vector of the EPL action. Extensor pollicis brevis (EPB), however, produces better thumb abduction and extension by virtue of its radial vector. The described anatomical variation of EPB extending the thumb interphalangeal joint (IPJ), therefore, gives the “best combination” of movements by a single-thumb extensor tendon. Materials and Methods We performed this transfer in six patients in whom the EPB was found to be extending the IPJ while checked intraoperatively. Three of these six patients were cases of radial nerve palsy and the other three presented with brachial plexus palsy. The outcome was assessed by measuring palmar and radial abduction of the thumb, Kapandji’s score, and Bincaz’s scale. Results We found satisfactory results in all the six patients. In our series, patients had an average radial extension of the thumb of 29.2 degrees and an average palmar abduction of the thumb of 65.7 degrees. On evaluation with the Bincaz score; one patient had excellent result, three patients had good results, and two patients had fair results. Conclusion In situations where EPL rerouting is not possible (as in cases where the donor tendon needs to reach the thumb from the ulnar side, for example, flexor carpi ulnaris), transfer to the EPB, provided it is extending the thumb IPJ, would produce better extension and abduction of the thumb than the transfer to the EPL.

Spontaneous Rupture of the Extensor Pollicis Longus with the Extensor Pollicis Brevis Deformity

2017 ◽  
Vol 22 (04) ◽  
pp. 535-537
Author(s):  
Kazuo Ikeda ◽  
Naoki Osamura ◽  
Kaoru Tada
Keyword(s):  
Spontaneous Rupture ◽  
Tendon Transfer ◽  
Extensor Pollicis Longus ◽  
Extensor Pollicis Brevis ◽  
Extensor Indicis Proprius ◽  
Excessive Load

This paper examines three cases of spontaneous ruptures of the extensor pollicis longus (EPL) with the extensor pollicis brevis (EPB) deformity. The patients ranged from 39 to 71 years old. Non-dominant hands were involved in all three cases. There were no trauma nor pathological cause of EPL ruptures. A tendon transfer using the extensor indicis proprius was performed in each case. Intraoperative findings showed hypoplastic EPB in one case and EPB defects in two cases. A weak or defective EPB puts an excessive load on the EPL, which might be one of the causes of spontaneous EPL rupture.

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