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

Lobo-Escolar, Luis; Moreno, I. López; Bosch-Aguilá, M.

doi:10.1016/j.jhsa.2016.11.012

Cited by 7 publications

(12 citation statements)

References 33 publications

(22 reference statements)

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“…Twenty reports were excluded; 13 were out of scope, and seven articles had insufficient details. Thus, a total of 37 articles with 371 cases 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 constituted the basis of this review.…”

Section: Resultsmentioning

confidence: 99%

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Etiology of Traumatic Causes of Extensor Pollicis Longus Tendon Rupture: A Systematic Review

Alsaedi,

Alshahir,

Alzahim

et al. 2024

Journal of Hand and Microsurgery

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Introduction The extensor pollicis longus (EPL) is a muscle that follows a complex anatomical course in the hand to allow for thumb extension. Almost all manual activities require the use of the EPL; therefore, when ruptured it can be very disabling for patients. The etiologies behind traumatic EPL rupture were mostly attributed to distal radius fracture in the literature. However, EPL rupture remains uncommon, and other traumatic etiologies exist. Therefore, this systematic review aimed to provide a holistic view of the traumatic etiologies behind the EPL rupture and fill the global lack of knowledge regarding this rare injury. Materials and Methods We searched among Cochrane Central Register of Controlled Trials (CENTRAL) Embase, Medline, and Cochrane Database of systematic review register databases via Ovid, with no restriction on the date, including studies containing data about the etiology of traumatic causes of EPL tendon rupture with available full text, and excluding non-English and animal studies. Results A total of 37 articles with 371 cases constituted the basis of this review. We classified the etiology of the EPL rupture into three groups according to the affected anatomical structure that caused the EPL rupture (fracture-related, soft tissue-related, and mallet thumb). Conclusion Distal radius fractures remain the most common cause of EPL rupture; however, other causes, such as lacerations, blunt trauma, and direct cuts to the EPL tendon, should be considered.

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Section: Resultsmentioning

confidence: 99%

“…Eleven articles observed 119 cases that developed EPL rupture (32% of all cases) after a soft tissue injury. 12 13 14 19 23 24 25 26 30 40 42…”

Section: Resultsmentioning

confidence: 99%

Etiology of Traumatic Causes of Extensor Pollicis Longus Tendon Rupture: A Systematic Review

Alsaedi,

Alshahir,

Alzahim

et al. 2024

Journal of Hand and Microsurgery

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“…The past literature has shown good functional outcomes using a free tendon graft to repair a chronic EPL tendon rupture, 4,16,17 Also, a creative method of making a lengthening flap using the EPL tendon stump for direct repair, which did not need a free tendon graft, and with good results, has been described. 3 Pillukat et al compared the surgical outcome of EIP tendon transfer and free interpositional tendon graft for the treatment of chronic EPL tendon rupture and reported comparable and satisfactory results for both groups. 7 Chung et al also compared tendon transfer and tendon grafting in rheumatoid arthritic patients with extensor tendon ruptures and reported equally satisfying results for both methods.…”

Section: Discussionmentioning

confidence: 99%

“…The main etiologies for EPL tendon rupture include mechanical irritation, attrition, and compromised vascular supply secondary to hemorrhage and pressure, 1,2 which are often caused by distal radius fracture, rheumatoid arthritis, synovitis, bony deformity, and certain occupational overuse. 3 The chronic nature of most EPL tendon ruptures makes it more challenging to treat due to tendon retraction and gap formation.…”

Section: Introductionmentioning

confidence: 99%

Tendon repair with intercalated partial extensor carpi radialis longus tendon graft for chronic extensor pollicis longus tendon rupture

Yin

et al. 2021

Journal of the Chinese Medical Association

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Background: The main treatment choices for chronic extensor pollicis longus (EPL) tendon rupture consists of tendon transfer and tendon repair with tendon graft. Tendon transfer with extensor indicis proprius (EIP) is currently considered the gold standard treatment which yields predictable and satisfactory results, but potentially compromises the strength of independent extension of the index finger. We propose our method of using a partial extensor carpi radialis longus (ECRL) tendon graft to repair chronic EPL tendon tears. Methods: The distal stump of the EPL was located through an incision at the basal joint level. The proximal stump was located through a curved incision at the dorsoradial wrist where the partial ECRL tendon graft was harvested. The tendon graft was subcutaneously transposed, sutured at both ends, and tensioned at full thumb extension with a neutral wrist position. Results: From March 2016 to June 2019, 23 patients (mean age: 59.7 years; mean follow-up: 29.6 months) were retrospectively reviewed. All the patients were followed for a minimum of 12 months. The final total active motion was 93.2% of the contralateral thumb. The mean Quick Disabilities of the Arm, Shoulder and Hand score was 6.0. There was one complication possibly due to poor EPL muscle quality, and the patient was subsequently treated with EIP tendon transfer. Conclusion: Our study showed that using a partial ECRL tendon graft to repair chronic EPL tendon rupture results in satisfactory functional outcomes. The advantages of this method include preservation of EIP function and using the same incision for graft harvesting and tendon repair. This method can be considered an alternative to EIP tendon transfer in patients with high demand for their index finger function.

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“…4,[6][7][8][9]22 Una desventaja podría ser la perdida funcional residual para la extensión del segundo dedo en contraposición con trabajos que apoyan la interposición tendinosa, con el EIP como recurso, ya que sostienen que se manipularía exclusivamente el tendón dañado; como desventaja la necesidad de realizar dos anastomosis con aumento de riesgo de fracaso técnico en uno de los extremos. 10,23 Algunos autores abogan por otras técnicas, Lobo y col. 24 propone un colgajo local de alargamiento de ambos cabos tendinosos para salvar la solución de continuidad. El ECRL 11 y el APL 10 también se proponen como alternativas.…”

Section: Discussionunclassified

Reparación del tendón extensor pollicis longus, mediante la técnica del lazo con el extensor pollicis brevis

Morenilla

Blanco

Delgado³

et al. 2018

Rev Iberoam Cir Mano

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Introducción Se presenta una alternativa quirúrgica a las técnicas convencionales para reparación de lesiones por herida o por mecanismo cerrado del tendón EPL, denominada lazo transfixiante y contínuo; el cual emplea el tendón de anclaje motor procedente del músculo EPB (Extensor Pollicis Brevis). El objetivo fundamental del estudio fue explicar el desarrollo de esa técnica y los resultados satisfactorios que muestra en la reparación de las lesiones completas del EPL. Material y método Se describe un nuevo nudo, conocido como lazo transfixiante y continuo, el cual emplea el tendón de anclaje motor procedente del músculo EPB (Extensor Pollicis Brevis), uniendo el tendón EPL lesionado con el tendón EPB, envolviendo a éste, sin desinsertar la unidad motora del EPB, recuperando con ello la función extensora del primer dedo de la mano. Se seleccionó una serie de 10 casos de rotura del EPL reparados con esa técnica, en contexto de accidente laboral. Se tomaron como variables; edad, profesión, sexo, lateralidad, dominancia, mecanismo lesional, momento de la intervención y presencia de lesiones asociadas. Seis de los casos se produjeron por mecanismo lesional cerrado (60%), y los 4 casos restantes mediante herida (40%). Resultados. Al finalizar el proceso, 9 pacientes presentaron como resultado curado (90%), mientras que sólo 1 de ellos resultado baremo (10%). No se observaron diferencias entre la extremidad sana y la extremidad operada en movilidad y en cuanto a resultados funcionales mediante tres mediciones; prensión, pinza terminoterminal y pinza lateral. Discusión el lazo continuo transfixiante para la reparación de lesiones del tendón EPL empleando el tendón EPB es un procedimiento que genera un rango funcional efectivo. Aporta unos resultados satisfactorios, en cuanto a la funcionalidad objetivada a través de test biomecánicos, alcanzando adecuada tasa de reincorporación laboral.

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

Abstract: Therapeutic IV.

Cited by 7 publications

References 33 publications

Etiology of Traumatic Causes of Extensor Pollicis Longus Tendon Rupture: A Systematic Review

Etiology of Traumatic Causes of Extensor Pollicis Longus Tendon Rupture: A Systematic Review

Tendon repair with intercalated partial extensor carpi radialis longus tendon graft for chronic extensor pollicis longus tendon rupture

Reparación del tendón extensor pollicis longus, mediante la técnica del lazo con el extensor pollicis brevis

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