EFFECTIVENESS OF MODIFIED EXTENSOR INDICIS PROPRIUS TENDON TRANSFER FOR RECONSTRUCTION OF SPONTANEOUSLY RUPTURED EXTENSOR POLLICIS LONGUS TENDON_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

ZHENG Xin , AN Hongbin , CHEN Tao , WANG Haibao.

Department of Hand Surgery, Taizhou Municipal Hospital, Taizhou Zhejiang, 318000, P.R.China. Corresponding author: AN Hongbin, E-mail: hongbinan@126.com;

Corresponding author：

Keywords：

Spontaneously ruptured extensor pollicis longus tendon; Extensor indicis proprius tendon; Functional reconstruction

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ObjectiveTo investigate the effectiveness of modified extensor indicis proprius (EIP) tendon transfer for reconstruction of spontaneously ruptured extensor pollicis longus (EPL) tendon by comparing with the traditional EIP tendon transfer. MethodsBetween January 2009 and December 2011, 11 cases of spontaneously ruptured EPL tendon were treated by modified EIP tendon transfer to reconstruct extension function (modified group). On the base of traditional procedure, the proximal end of EPL tendon was sutured with EIP tendon and the distal end of EIP tendon was crossed round extensor pollicis brevis (EPB) tendon and sutured back with EPL tendon. A specific EI-EPL evaluation method (SEEM) was used to measure the EPL tendon function after transfer. The result was compared with that of the other 18 cases undergoing traditional operation (traditional group). There was no significant difference in gender, age, disease duration, and injury causes between 2 groups (P gt; 0.05). ResultsAll incisions healed by first intention. In traditional group, 5 cases were out of follow-up, and the other 24 cases were followed up 1 year and 6 months on average (range, 8 months-2 years and 6 months). At the last follow-up, according to the evaluation of SEEM, the thumb elevation and flexion deficits of modified group were significantly less than those of traditional group (P lt; 0.05). The independent elevation deficit of the index finger of modified group was similar to that of traditional group (P gt; 0.05). The effectiveness was excellent in 9 cases and good in 2 cases with an excellent and good rate of 100% in modified group, and was excellent in 5 cases, good in 6 cases, and fair in 2 cases with an excellent and good rate of 84.6%. The effectiveness of modified group was significantly better than that of traditional group (χ2=0.03, P=0.03). ConclusionReconstruction of EPL tendon function by modified EIP tendon transfer is effective and easy. It can increase strength of the transferred tendon and obtain satisfactory results, but the long-term effectiveness needs further follow-up.

Citation： ZHENG Xin,AN Hongbin,CHEN Tao,WANG Haibao.. EFFECTIVENESS OF MODIFIED EXTENSOR INDICIS PROPRIUS TENDON TRANSFER FOR RECONSTRUCTION OF SPONTANEOUSLY RUPTURED EXTENSOR POLLICIS LONGUS TENDON. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(9): 1074-1076. doi: Copy

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2.	Hung JY, Wang SJ, Wu SS. Spontaneous rupture of extensor pollicis longus tendon with tophaceous gout infiltration. Arch Orthop Trauma Surg, 2005, 125(4): 281-284.
3.	沈尊理, 贾万新, 侯明钟, 等. 类风湿关节炎致自发性手指肌腱断裂的临床分析. 中华手外科杂志, 2007, 23(3): 140-142.
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5.	熊革, 郑炜, 刘沐青, 等. 拇长伸肌腱腱鞘炎合并肌腱嵌顿一例报告. 中华手外科杂志, 2006, 22(2): 128.
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8.	詹海华, 阚世廉, 费起礼, 等. 食指固有伸肌腱移位重建拇长伸肌功能及评价. 中国修复重建外科杂志, 2004, 18(4): 301-303.
9.	Figl M, Mayer M, Lederer S, et al. Extensor pollicis longus rupture after distal radius fracture: results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting. Wien Klin Wochenschr, 2011, 123(15-16): 485-487.
10.	Choi JC, Kim WS, Na HY, et al. Spontaneous rupture of the extensor pollicis longus tendon in a tailor. Clin Orthop Surg, 2011, 3(2): 167-169.
11.	魏壮, 崔树森, 刘飙, 等. 拇长伸肌腱自发性断裂的临床分析及治疗. 中国修复重建外科杂志, 2006, 20(2): 200-201.
12.	王仁润, 姚建华, 朱兵, 等. 拇长伸肌腱自发性断裂桡侧腕短伸肌腱替代术的临床应用. 中华手外科杂志, 2008, 24(5): 260-262.
13.	Fujita N, Doita M, Yoshikawa M, et al. Spontaneous rupture of the extensor pollicis longus tendon in a professional skier. Knee Surg Sports Traumatol Arthrosc, 2005, 13(6): 489-491.

1. Björkman A, Jörgsholm P. Rupture of the extensor pollicis longus tendon: a study of aetiological factors. Scand J Plast Reconstr Surg Hand Surg, 2004, 38(1): 32-35.
2. Hung JY, Wang SJ, Wu SS. Spontaneous rupture of extensor pollicis longus tendon with tophaceous gout infiltration. Arch Orthop Trauma Surg, 2005, 125(4): 281-284.
3. 沈尊理, 贾万新, 侯明钟, 等. 类风湿关节炎致自发性手指肌腱断裂的临床分析. 中华手外科杂志, 2007, 23(3): 140-142.
4. 李大为, 姜德欣. 舟骨陈旧性骨折致拇长屈肌腱自发性断裂一例. 中华手外科杂志, 2006, 22(6): 323.
5. 熊革, 郑炜, 刘沐青, 等. 拇长伸肌腱腱鞘炎合并肌腱嵌顿一例报告. 中华手外科杂志, 2006, 22(2): 128.
6. 韦加宁. 手外科手术图谱. 北京: 人民卫生出版社, 2003: 242-244.
7. Lemmen MH, Schreuders TA, Stam HJ, et al. Evaluation of restoration of extensor pollicis function by transfer of the extensor indicis. J Hand Surg (Br), 1999, 24(1): 46-49.
8. 詹海华, 阚世廉, 费起礼, 等. 食指固有伸肌腱移位重建拇长伸肌功能及评价. 中国修复重建外科杂志, 2004, 18(4): 301-303.
9. Figl M, Mayer M, Lederer S, et al. Extensor pollicis longus rupture after distal radius fracture: results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting. Wien Klin Wochenschr, 2011, 123(15-16): 485-487.
10. Choi JC, Kim WS, Na HY, et al. Spontaneous rupture of the extensor pollicis longus tendon in a tailor. Clin Orthop Surg, 2011, 3(2): 167-169.
11. 魏壮, 崔树森, 刘飙, 等. 拇长伸肌腱自发性断裂的临床分析及治疗. 中国修复重建外科杂志, 2006, 20(2): 200-201.
12. 王仁润, 姚建华, 朱兵, 等. 拇长伸肌腱自发性断裂桡侧腕短伸肌腱替代术的临床应用. 中华手外科杂志, 2008, 24(5): 260-262.
13. Fujita N, Doita M, Yoshikawa M, et al. Spontaneous rupture of the extensor pollicis longus tendon in a professional skier. Knee Surg Sports Traumatol Arthrosc, 2005, 13(6): 489-491.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF MODIFIED EXTENSOR INDICIS PROPRIUS TENDON TRANSFER FOR RECONSTRUCTION OF SPONTANEOUSLY RUPTURED EXTENSOR POLLICIS LONGUS TENDON

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