Bhardwaj Praveen, Varadharajan Vigneswaran, Sabapathy S Raja
Department of Hand, Wrist Surgery and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
Department of Plastic, Hand and Reconstructive Microsurgery, Ganga Hospital, Coimbatore, Tamilnadu, Indiaa.
Indian J Plast Surg. 2020 Dec;53(3):435-438. doi: 10.1055/s-0040-1721859. Epub 2020 Dec 25.
Extensor indicis proprius (EIP) tendon transfer is a standard operation for restoration of the thumb extension following rupture of extensor pollicis longus (EPL). In its standard form often the EIP is transferred to the EPL without inspection of the extensor tendons in the fourth compartment and it is retained in its anatomical fourth compartment. However, in a setting of EPL rupture in relation to the distal radius fracture (with or without fixation), concomitant injury to the extensor tendons to the index finger may result in failure of the transfer and even a loss of index finger extension (index finger drop) further complicating the reconstruction and resulting in immense patient dissatisfaction. We herein present two such rare cases to highlight this clinical scenario and how an awareness of this possibility and inspection of the extensor tendons to the index finger before EIP transfer allowed us to prevent this complication. In essence, if we know it, we can prevent it.
示指固有伸肌（EIP）肌腱转位是拇长伸肌（EPL）断裂后恢复拇指伸展功能的标准手术。在其标准术式中，通常将EIP转位至EPL，而不检查第四伸肌间隔内的伸肌腱，并将其保留在解剖学第四伸肌间隔内。然而，在桡骨远端骨折（无论有无内固定）相关的EPL断裂情况下，示指伸肌腱的合并损伤可能导致转位失败，甚至导致示指伸展功能丧失（示指下垂），进一步使重建复杂化，并导致患者极大不满。我们在此介绍两例此类罕见病例，以突出这种临床情况，以及在EIP转位前意识到这种可能性并检查示指伸肌腱如何使我们能够预防这种并发症。从本质上讲，如果我们了解它，就可以预防它。
