Functional Recovery Following an L-Lengthening Local Tendon Flap for Extensor Pollicis Longus Chronic Ruptures.

PURPOSE: Extensor indicis proprius tendon transfer has been considered the reference standard technique for extensor pollicis longus (EPL) chronic ruptures, but relevant complications have been reported. We describe a new reconstructive technique for chronic EPL ruptures and assess functional recovery after this procedure.

METHODS

We observed 31 patients who fulfilled inclusion criteria an average of 6.8 months after treatment. An L-shaped local tendon flap was prepared by making a transverse incision to the middle of the tendon and then longitudinally toward the end of one of the tendon stumps. Absorbable suture was used to coapt the free ends and as a reinforcement suture. We used the total active motion scale to classify results.

RESULTS

Total active motion in patients who completed the follow-up period was 89% of the normal side; 97% of patients returned to their previous employment. Surgical complications were infrequent and only one patient (3%) required surgery for extensor tendon adhesions.

CONCLUSIONS

This technique permits reconstruction of the EPL tendon without the need for a tendon graft or tendon transfer.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.