Extensor indicis proprius transfer for loss of extensor pollicis longus function

Abstract

In the period 1969-1991, 46 extensor indicis proprius tendon transfers were performed for functional loss of extensor pollicis longus. The long-term function of the thumb was reviewed in 22 patients with an average follow-up of 7 years. Based on Geldmacher's evaluation scheme for assessment of the results of extensor tendon reconstruction, we report 5 excellent (23%), 4 good (18%), 12 satisfactory (55%) and 1 poor (4%) result. The mean loss of pinch strength was 8% compared with the contralateral, non-operated thumb. Subjectively, the majority of the patients (86%) described no limitations in their daily life activities. It is recommended that the transfer be tight enough to give full thumb extension and that the hand be immobilized with the thumb in this position for 4 weeks.

Early Free Active Versus Dynamic Extension Splinting After Extensor Indicis Proprius Tendon Transfer to Restore Thumb Extension: A Prospective Randomized Study

“…Usually, extensor indicis proprius tendon transfer is not used for open lacerations unless primary repair is not feasible (ie, tendon defect). The surgical technique is relatively similar throughout the studies reported in the literature, with most groups using a braided Pulvertaft suture technique, [1][2][3][4][5][6][7][8] however the postoperative hand therapy regimens range from immobilization for 3 to 5 weeks, 5,6,9,10 to early dynamic extension splinting, 1 to complete free active protocols (W. Hintringer, personal communication; C. Pazourek, presented at the German-Speaking Society for Surgery of the Hand Meeting, 2007). Based on the experiences of Browne and Ribik 11 and of Moore et al, 12 the authors of the current study were previously able to demonstrate the expeditious recovery of thumb extension by an early dynamic extension splinting protocol.…”

Extensor indicis-transfer compared with palmaris longus transplantation in reconstruction of extensor pollicis longus tendon: A retrospective study

“…Addition of the single scores results in an estimation of total outcome. Limited function of the index finger is one of the disadvantages of EIT, apparent both as postoperative weakness and limitation of extension, mainly in flexion of fingers IIIÁV [1,3,7]. However, this limitation does not seem to be relevant for most patients, as Noorda et al found limited function of the index finger in all of his 34 patients, but no complaints on subjective assessment in 30 (88%) patients [8].…”

Die sekundäre Rekonstruktion der Sehne des Musculus extensor pollicis longus

“…[4] verwendet, das bereits von zahlreichen Autoren, insbesondere auch zur Beurteilung der Nachuntersuchungsergebnisse nach Rekonstruktion der EPL-Sehne, verwendet wurde [6,8,9,11]. Dabei wird die Gesamtfunktion des betroffenen Daumens im Vergleich zur gesunden Gegenseite beurteilt.…”

“…Auf der anderen Seite kann eine Sehnentransposition auch dann noch durchgeführt werden, wenn der Motor der langen Daumenstrecksehne nicht mehr funktionstüchtig ist, und die postoperativen Ergebnisse sind insgesamt besser abschätzbar. Dabei wird die Transposition des Extensor indicis (EIT) von den meisten Autoren bevorzugt [9].…”