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

Either an extensor indicis transposition (EIT) or an intercalated free tendon graft (FTG) can be used for secondary reconstruction of the extensor pollicis longus (EPL) tendon. We reviewed 1469 cases of extensor tendons repaired between 1992 and 2003 and compared the results. In only 55 patients was an isolated secondary reconstruction of the EPL done. Forty-five patients (82%) were available for clinical follow-up after a mean of 4.3 (range 2-11) years (28 (62%) who had EIT and 17 (38%) who had FTG). Thumb function was assessed postoperatively using Geldmacher's criteria, and the uninjured thumb served as control. The comparison showed no significant differences between the procedures for the single variables evaluated, or for the injured and other (uninjured) thumb in either group. For isolated secondary reconstruction of the EPL tendon, both the extensor indicis transposition and a free autologous tendon graft successfully restore thumb function. Therefore, both surgical techniques can be considered equal alternatives.