• Hand Surg Rehabil · Dec 2020

    Reconstruction strategies after rupture of the extensor pollicis longus tendon: A systematic review.

    • S Ganon, J Bellity, D Zbili, and D Boccara.
    • Plastic, Esthetic and Reconstructive Surgery, Saint-Louis Hospital, Paris, France, APHP, 1st Claude Vellefaux Avenue, 75010 Paris, France. Electronic address: shabganon@gmail.com.
    • Hand Surg Rehabil. 2020 Dec 1; 39 (6): 502-507.

    AbstractRuptures of the extensor pollicis longus (EPL) tendon result in a major loss of function. The most practiced reconstruction surgery appears to be extensor indicis proprius (EIP) transfer, which is contraindicated in certain cases. The objective of this review was to present the various reconstruction methods for the EPL tendon. A systematic review was conducted of the literature from 2010 to 2020 on strategies for reconstructing the EPL tendon. A search of the PubMed database was done using the following keywords: 'extensor', 'pollicis', 'longus', and 'thumb'. Data analyzed were the type of study, the number of patients, surgery, follow-up, and results. Of the 142 articles selected from PubMed, only 18 (12.7%) were included in the analysis. Follow-up ranged from 6 months to 6 years, with an average of 28 months, and the total number of patients was 515. Numerous strategies exist for reconstruction following rupture of the EPL tendon. The preferred modality seems to be a transfer of the EIP tendon with intraoperative testing of applied tension with the interphalangeal joint in extension, hand flat, forearm in pronation, and neutral wrist position. When the EIP is not available, other transfers should be considered if the patient has significant tendon attrition, or a graft should be considered if an isolated defect is present.Copyright © 2020 SFCM. Published by Elsevier Masson SAS. All rights reserved.

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