Extensor indicis transfer improves function in patients after rupture of the extensor pollicis longus tendon

Abstract

The primary aim was to determine the improvement in patient-reported functional outcomes (PROMs) following extensor indicis proprius (EIP) transfer for a closed rupture of the extensor pollicis longus (EPL) tendon. Secondary aims were to analyze the impact of this procedure on health-related quality of life (HRQoL) and satisfaction. Preoperative and one-year postoperative PROMs were collected prospectively at a single institution over a two-year period (2014-2016). The primary outcome measure was the QuickDASH score. Patients also completed satisfaction scores, and the EQ-5D-5L score was used to evaluate HRQoL. Paired data was available for 12 patients (92%) at mean 19 months following surgery. A statistically-significant improvement in mean QuickDASH score was observed from 29.7 (SD: 21.7) preoperatively to 15.2 (SD: 16.4) postoperatively (p?=?0.05). Nine patients reported an improvement, one patient reported no change, and the remaining two reported deterioration in QuickDASH score. Median EQ-5D-5L improved significantly from 0.82 (IQR: 0.71 – 1.0) to 0.93 (0.77 to 1.0) postoperatively (p?<?0.05). Eleven patients were satisfied and no complications were reported. This study has demonstrated an improvement in upper-limb specific function and HRQoL following EIP transfer for rupture of the EPL. This procedure was also associated with a low rate of complications and a high rate of patient satisfaction. Level of evidenceIII (cohort study).