Tension setting for extensor indicis proprius to extensor pollicis longus transfer using the wide-awake approach

Abstract

Objectives: The tendon transfer operation is the most preferred surgical method for chronic extensor pollicis longus (EPL) tendon rupture repair. The key factor in these operations is tension setting of the tendon transfer. In this article, we retrospectively reviewed our extensor indicis proprius (EIP) to EPL transfer cases for chronic EPL ruptures. Methods: Five patients were operated on for chronic rupture of the EPL tendon between December of 2011 and April of 2014. The EIP tendon was transferred to the EPL tendon using the wide-awake approach in order to optimally set the tension. Results: All five patients were able to extend their thumbs. No second operation was needed for tension adjusting. No complications were encountered postoperatively and during the follow-up period. Conclusion: Tendon transfers using the wide-awake approach provides the benefit of improved tendon tension setting with active movement and minimal risks of complication.