Extensor Indicis Proprius Tendon Transfer for Extensor Pollicis Longus Rupture

Abstract

Six of 13 patients who underwent extensor indicis proprius (EIP) tendon transfer for extensor pollicis longus (EPL) rupture between 1985 and 1998 were available for long term assessment of the function of the thumb. The presenting problem was the inability to extend the thumb at the interphalangeal (IP) joint. Postoperatively, there was no extension lag at the IP joint of the thumb. Three patients had slightly reduced flexion at the IP joint compared with the unaffected thumb. Five patients showed no extension lag at the metacarpophalangeal (MCP) joint, whereas one patient had an extension lag of 28°. The mean active flexion at the IP joint of the thumb was 64.5° (range 50° to 77.5°). The mean extension deficit of the index finger at the MCP joint was 7° (range 0° to 20°) compared with the unaffected side that was 5° (range 0° to 12°). Measurements of key pinch and pinch grip were 94% and 82% in the unaffected hand, respectively. Subjective assessment by the patients was rated as excellent by four patients and good by two patients. This particular tendon transfer is recommended for the treatment of EPL rupture.