J Med Assoc Thai 2017; 100 (7):765

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Postoperative Hand Function of Extensor Indicis Proprius Tendon Transfers in Treatment of Extensor Pollicis Longus Rupture in Non-Displaced Fracture of the Distal Radius
Luenam S Mail, Jiratummarat P , Kosiyatrakul A

Objective: Extensor pollicis longus (EPL) ruptures are a well-documented complication of non-displaced distal radius
fractures. The extensor indicis proprius (EIP) tendon transfers have been widely used for the treatment of this condition. The
purpose of the present study was to provide the information regarding the postoperative outcomes and donor morbidity of
EIP transfer in the EPL rupture following the non-displaced distal radius fracture.
Material and Method: Between 2006 and 2015, 16 patients with rupture of EPL following the non-displaced distal radius
fracture underwent EIP tendon transfer were included in the present study. The average time of EPL rupture was 14.4 weeks
following the fracture (range 6 to 28 weeks). All operations were performed by the same surgeon. The EIP was transferred
through a retinacular pulley in the fourth dorsal compartment with the standard tensioning technique. The mean follow-up
period was 22 months (range 11 to 78 months). The thumb range of motion, pinch strength, grip strength, the extension deficit and strength of the donor index, the Disabilities of the Arm, Shoulder and Hand (DASH) score, a specific EIP-EPL evaluation method (SEEM), and subjective assessment were evaluated.
Results: All patients had Kapandji thumb opposition score of 10 points. Thumb elevation deficit averaged 4.5 cms. No patient
demonstrated the dependent and independent extension lag of index; however, the extension strength was decreased to that of
60% of the normal finger. The DASH score had improved from averaged 37.4 preoperatively to 11.1 postoperatively. The result according to the SEEM was good in eight patients and satisfactory in eight patients. All patients thought that they had
good result from subjective assessment.
Conclusion: The EIP transfer provides significant improvement of the hand function in the patient who has the complication of EPL tendon rupture following the non-displaced fracture of the distal radius. High satisfactory rate with minimal donor morbidity was observed in the treatment of this specific group of patient.

Keywords: Extensor pollicis longus rupture, Rupture, Tendon transfer, Extensor indicis proprius, Non-displaced, Fracture of
the distal radius

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Related Correction: CORRECTION (Vol 100, No 11: NOVEMBER 2017)