Arch Hand Microsurg.  2017 Dec;22(4):224-232. 10.12790/ahm.2017.22.4.224.

Comparison of Palmaris Longus Tendon Graft and Extensor Indicis Proprius Tendon Transfer for Reconstruction of the Extensor Pollicis Longus Tendon

• Lee JM
• Hyun MJ
• Seo KB

• KMID: 2406125
• DOI: http://doi.org/10.12790/ahm.2017.22.4.224

Abstract

PURPOSE
To compare the results of reconstruction of extensor pollicis longus tendon treated by palmaris longus tendon graft and extensor indicis proprius tendon transfer.
METHODS
Authors have performed reconstruction of the delayed 27 cases of the ruptured extensor pollicis longus tendon from March 2006 through February 2016 at Jeju National University Hospital with either palmaris longus tendon graft or extensor indicis proprius tendon transfer. Out of 27 patients, 12 patients were treated by palmaris longus tendon graft and 15 patients were treated by extensor indicis proprius tendon transfer. Postoperatively thumbs were immobilized with thumb spica short arm splint in extension and abduction position for 4 weeks. Active and passive exercise of the thumb with extension and abduction was recommended. The functions of the thumbs were assessed by the Riddell's classification and statistically compared.
RESULTS
At average 21.7 months follow-up, 13 cases (48.1%) were excellent, 11 cases (40.7%) were good, and 3 cases (11.1%) were fair according to the functional evaluation of Riddell. No significant differences were noted between two groups except the operation time.
CONCLUSION
Ruptured extensor pollicis longus tendon could be reconstructed with palmaris longus tendon graft or extensor indicis proprius tendon transfer and final functional outcome could be good in long-term follow-up.

Keyword

Extensor pollicis longus tendon; Palmaris longus tendon graft; Extensor indicis proprius tendon transfer

MeSH Terms

Arm
Classification
Follow-Up Studies
Humans
Splints
Tendon Transfer*
Tendons*
Thumb
Transplants*

Figure

• 

  Fig. 1 Tendon transfer with extensor indicis proprius tendon. (A) A photograph shows limited extension of the right thumb caused by ruptured extensor pollicis longus tendon. (B) Proximal and distal end of ruptured extensor pollicis longus tendon is identified. (C) Extensor indicis proprius tendon was obtained. (D) The proximal part of extensor indicis proprius tendon and the distal end of the extensor pollicis longus tendon was sutured with Pulvertaft method with wrist in neutral position and thumb extended. (E) A photograph shows extension and dorsal elevation of right thumb at last follow-up visit.

• 

  Fig. 2 Interpositional tendon graft with Palmaris longus tendon. (A) Identification of the proximal and distal end of the ruptured extensor pollicis longus tendon. (B) Palmaris longus tendon was obtained. (C) The free tendon graft with Palmaris longus tendon was done with Pulvertaft method with wrist in neutral position and thumb extended. (D) A photograph shows extension and dorsal elevation of left thumb at last follow-up visit.

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