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Epl rupture tendon repair

Hamadi A Murphy, Viral V Jain, Shital N Parikh, Eric J Wall, Roger Cornwall, Charles T Mehlman
BACKGROUND: Extensor pollicis longus (EPL) tendon injury following the dorsal approach to elastic stable intramedullary nailing (ESIN) of the radius has been reported in a growing number of cases in the literature. This study includes 5 new cases from our institution as well as a comprehensive review of previously reported cases from the literature. METHODS: We conducted a retrospective chart review of all patients undergoing ESIN between January 1, 2004 and December 31, 2013 at our institution...
November 7, 2016: Journal of Pediatric Orthopedics
Ravi M Dissanayake, Peter Moore, Gregory M McCarten
We present the case of a closed traumatic disruption of the thumb radial sagittal band (RSB) that sonographically mimicked rupture of the extensor pollicis longus (EPL) tendon. This injury was treated with primary repair of the RSB and lead to a good functional outcome for the patient. This case report highlights how early recognition and treatment can lead to a good functional outcome.
June 2016: Journal of Hand Surgery Asian-Pacific Volume
Adam K Lee, John D Beck, William M Mirenda, Joel C Klena
BACKGROUND: Elastic stable intramedullary nailing (ESIN) is an effective means of fixation for unstable, pediatric forearm shaft fractures with the benefit of smaller incisions, less soft tissue manipulation, and ease of removal. This study was designed to evaluate the incidence of and risk factors for extensor pollicis longus (EPL) rupture after fixation of pediatric radial shaft fractures with ESIN. METHODS: A retrospective review of all patients younger than 19 years who had a repair of a forearm fracture with flexible intramedullary nailing between 2006 and 2011 was performed...
December 2016: Journal of Pediatric Orthopedics
Ben Brooker, P Christian Harris, Leo T Donnan, H Kerr Graham
INTRODUCTION: Diaphyseal forearm fractures are common in children and adolescents. Intramedullary fixation with flexible nails has a high success rate. Complications related to the insertion of the radial nail include injury to the superficial branch of the radial nerve and rupture of the extensor pollicis longus (EPL) tendon. MATERIALS AND METHODS: We report a series of nine patients who sustained an EPL injury related to the insertion of an elastic intramedullary nail into the radius...
August 2014: Journal of Children's Orthopaedics
Anuj Jain, Naveen Goyal, Puneet Mishra
Spontaneous rupture of the extensor pollicis longus (EPL) tendon is rare, and spontaneous non-traumatic rupture of both extensor pollicis longus (EPL) and extensor carpi radialis brevis (ECRB) tendons is not reported in literature. Rupture of EPL is usually associated with rheumatoid arthritis, systemic or local steroid injections, fractures of the wrist and repetitive and excessive abnormal motion of the wrist joint. We describe a case of spontaneous rupture of the EPL and ECRB tendons in a female patient, washerwoman by occupation, with no predisposing factor...
2014: Hand Surgery
T Waitzenegger, L Lantieri, D Le Viet
The authors report on 11 cases of ulnar dislocation of the extensor pollicis longus (EPL) due to rupture of the dorsal aponeurosis at the thumb metacarpophalangeal (MCP) joint. This condition is rare. By performing a descriptive study of this injury, we were able to establish a classification system for thumb extensor tendon dislocation. The series included 11 patients with a mean age of 27years. All patients presented with either varus or rotational thumb injury. This resulted in an active extension deficit in the thumb MCP joint with EPL dislocation behind the MCP...
September 2014: Chirurgie de la Main
Jose M Abad, Ignacio Garcia-Lopez, Eduardo F Torrejón, Fernando Garcia de Lucas
Ruptures of extensor pollicis longus (EPL) tendon may need a tendon transfer for repair, especially in chronic ruptures. We describe a novel transfer technique using a loop-tendon suture for dynamic transfer of extensor pollicis brevis to EPL. We performed an end-to-side transfixing-loop self-locking suture preserving the extensor pollicis brevis, which acts as a motor unit for the distal end of the repaired tendon. Contraindications would mainly be simultaneous rupture of EPL and brevis tendons. No complications were observed, except for mild metacarpal-phalangeal stiffness in chronic ruptures...
June 2014: Techniques in Hand & Upper Extremity Surgery
Erin M Rada, Sachin M Shridharani, Scott D Lifchez
INTRODUCTION: Extensor pollicis longus (EPL) tendon rupture is a well-described phenomenon in patients with rheumatoid arthritis. Mechanisms of EPL tendon rupture in the nonrheumatoid population have also been described and include traumatic rupture, repetitive motion strain, and steroid injection into the tendon. METHODS: The operative records for patients undergoing extensor pollicis longus reconstruction by the senior author were reviewed. Patients with a history of trauma to the wrist or inflammatory arthropathy were excluded...
2013: Eplasty
Panagiotis G Tsailas, Asterios Alvanos
A 73-year-old female suffered spontaneous rupture of the extensor pollicis longus (EPL) and extensor pollicis brevis (EPB) tendons, for which she presented for treatment three to four weeks later. At that time there was no active metacarpophalangeal (MCP) or interphalangeal (IP) extension, leading to severe functional impairment of her hand. Since both the EPL and the EPB tendons were ruptured, transfer of the extensor indicis proprius (EIP) tendon was carried out for the EPL and transfer of the accessory abductor pollicis longus (AAPL) was carried out for the EPB...
2012: Hand Surgery
Markus Figl, Michael Mayer, Stefan Lederer, Robert Bogner, Martin Leixnering
Injury of the extensor pollicis longus tendon is one of the commonest extensor tendon injuries after distal radius fracture. In 2003-2005 we performed extensor indicis transfer in 31 patients with loss of function of the EPL tendon and postoperative dynamic splinting. In 25 patients, a distal radius fracture managed surgically led to the EPL rupture (wire internal fixation in 23 patients, plate internal fixation in 2 patients). In 6 patients, the cause was a distal radius fracture treated conservatively. Out of our 25 followed-up patients, 9 (36%) had a very good and 15 (60%) a good result in the Geldmacher score...
August 2011: Wiener Klinische Wochenschrift
D Perugia, M Ciurluini, A Ferretti
We report an exceptional case of an acute spontaneous rupture of the extensor pollicis longus (EPL) tendon in a 16-year-old professional goalkeeper treated by primary surgical repair. Eight weeks after surgery, full thumb motion was regained. Four months after the surgical procedure, the patient resumed playing at the same level and he had no complaint at the 12-month follow-up. The anatomical alteration of Lister's tubercle and the consequent microinstability, associated with overuse and overloading, appeared to be the cause of the EPL tendon rupture...
April 2009: Scandinavian Journal of Medicine & Science in Sports
Peter Schaller, Wolfgang Baer, Hans-Dieter Carl
Either an extensor indicis transposition (EIT) or an intercalated free tendon graft (FTG) can be used for secondary reconstruction of the extensor pollicis longus (EPL) tendon. We reviewed 1469 cases of extensor tendons repaired between 1992 and 2003 and compared the results. In only 55 patients was an isolated secondary reconstruction of the EPL done. Forty-five patients (82%) were available for clinical follow-up after a mean of 4.3 (range 2-11) years (28 (62%) who had EIT and 17 (38%) who had FTG). Thumb function was assessed postoperatively using Geldmacher's criteria, and the uninjured thumb served as control...
2007: Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery
Kazunari Ishida, Hiroyuki Fujioka, Ryoichi Doi
Acute tendon rupture of the extensor pollicis longus (EPL) is rare. We present acute EPL tendon rupture associated with avulsed fracture of the second metacarpal at the insertion of extensor carpi radialis longus. Tendon rupture of the EPL was repaired with end-to-end suture and avulsed fracture of the second metacarpal base was treated with open reduction and internal fixation.
2006: Hand Surgery
A R Khandwala, J Blair, S B Harris, A J Foster, D Elliot
We present the results of repair and early mobilization of 100 extensor pollicis longus (EPL) tendon injuries in zones 1 to 4 in 100 patients using a dynamic outrigger splint which controlled metacarpophalangeal joint movements but allowed free movement of the interphalangeal joint. Eighty-two were complete divisions of the tendon and 18 were 80% to 99% tendon divisions. Analysis of measurements obtained routinely at 8 weeks showed 81% excellent and good results using the TAM system. There were 90% excellent and good results in the 72 patients, who were followed-up and received therapy for 12 weeks...
June 2004: Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand
F H Peck, S M Kennedy, J S Watson, V C Lees
Practitioner-led hand clinics were introduced in our unit in the year 2000 as a response to the high and increasing number of postoperative hand trauma patients coming to consultant clinics. The aim of this study was to evaluate the influence of these clinics on rupture rates following primary tendon repair in the hand. The study specifically examined:zone II flexor tendon repairsflexor pollicis longus (FPL) tendon repairsextensor pollicis longus (EPL) tendon repairs. Prospective data collection were undertaken for these particular operations over a 17-month study period...
January 2004: British Journal of Plastic Surgery
S Winckler, T Westphal, E Brug
During a period of 13 years we performed 56 extensor indicis proprius (EIP) transpositions for reconstruction of the ruptured or severed extensor pollicis longus tendon. The open injuries (n = 9) involved failed primary repair or untreated tendon injuries. The subcutaneous ruptures occurred after distal radius fractures (n = 17) or other closed injuries of the wrist (n = 10), without trauma in 14 patients and in 6 patients by rheumatoid synovialitis or collagenosis. 35 patients returned for follow-up examination 8 months to 10...
May 1995: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
R I Gelb
Reviewing the history and etiology of extensor pollicis longus tendon rupture shows the most compelling mechanism of rupture apparently is interruption of the tendon's vascularity secondary to hemorrhage and pressure, which causes the damaged tendon to be more susceptible to rupture secondary to late ischemic necrosis and attrition. Treatment options tried have included direct repair, tendon grafting, and tendon transfer. The authors recommend the extensor indicis proprius tendon transfer as the most predictable procedure to restore the original function of the EPL...
August 1995: Hand Clinics
U Albers, U Bültmann, D Buck-Gramcko
Transposition of the extensor indicis seems to be the most common procedure for reconstruction of the ruptured or severed extensor pollicis longus (EPL) tendon. From 1959 to 1988, we performed 115 extensor indicis transpositions in 34 open EPL injuries and 81 subcutaneous EPL ruptures. The open injuries involved failed primary repair (n = 6) or untreated tendon injuries (n = 19). The subcutaneous ruptures occurred after distal radius fractures or other closed injuries of the wrist (n = 62), arthrosis or rheumatoid synovialitis (n = 8)...
May 1992: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
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