A straightforward tendon transfer technique for extensor pollicis longus tendon rupture

Extensor indicis proprius (EIP) tendon transfer has traditionally been the preferred surgical modality for the treatment of extensor pollicis longus (EPL) tendon rupture. In this study, we report a case series of EPL to extensor pollicis brevis (EPB) tendon transfers for the treatment of EPL tendon rupture. This retrospective observational study included patients with acute EPL tendon rupture following distal radius fracture. Patients were evaluated at 3, 6, and 12 months postoperatively. Outcome measures included grip strength, thumb range of motion (ROM), and pain assessment using the Visual Analog Scale (VAS). The functional Kapandji score was also recorded to assess thumb opposition. Patient satisfaction was assessed using a 5-point Likert scale. The mean operative time was 27.1 min, with a mean incision length of 3.1 cm. The affected hand regained 82.3% of grip strength at 3 months, 87.1% at 6 months, and 88.2% at 12 months postoperatively. The dominance-adjusted recovery rates of grip strength were 74.0% at 3 months, 78.4% at 6 months, and 79.4% at 12 months. Mean thumb interphalangeal (IP) ROM improved from 80.0° at 3 months to 88.8° at 6 and 12 months. Metacarpophalangeal (MCP) joint ROM reached full recovery (50.0°) by 6 months. The mean Kapandji score improved from 8.6 at 3 months to 10 at both 6 and 12 months. All patients reported a VAS pain score of 0 throughout follow-up and expressed full satisfaction with the surgical outcome. EPL to EPB tendon transfer appears to be a feasible option for restoring thumb extension in elderly patients with EPL rupture. Early functional outcomes were satisfactory, with good restoration of thumb motion and grip.