Tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis: A long-term follow-up.

PURPOSE: The present study aimed to investigate the long-term functional and clinical outcomes of a tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis.

METHODS AND MATERIALS: From June 2005 to September 2012, eight patients (six males; two females) with a mean age of 30 years (range, 16-52 years) who suffered rupture or division of extensor pollicis longus underwent a tendon transfer to restore the extension of the thumb using the extensor carpi radialis brevis. The range of motion, pinch, and grip strength of thumb were compared with the nonoperated hand and evaluated for all the study patients using the Geldmacher scoring system.

RESULTS: At an average follow-up of 56 months, all eight patients could extend their thumbs fully and were assessed as good or excellent according to the Geldmacher scoring system. Average grip and tip pinch strengths of the operated hand were 95% (34.9 kg ± 14.0 kg vs. 36.6 kg ± 14.6 kg) and 92% (9.2 kg ± 4.8 kg vs. 9.9 kg ± 4.7 kg) of the nonoperative side, respectively. There was no marked loss of extension motion or strength of the wrist nor any other postoperative complications.

CONCLUSIONS: The procedure of transferring the extensor carpi radialis brevis tendon to the extensor pollicis longus provides excellent long-term clinical results for restoring the extension of the thumb. The procedure is safe, with few complications, and it can be an alternate procedure of restoring the extension of the thumb.