The extensor tendon to the thumb's interphalangeal joint lies adjacent to the distal radius. This tendon---the extensor pollicis longus (EPL)-- allows you to give the "thumb's up" sign, and can be visualized best when you place your palm flat on a table top and then try to lift your thumb up. Occasionally a fracture can result in an acute rupture of this tendon; or, it may develop during the post injury period because of an initial injury, and subsequent attrition.
This injury can be overlooked acutely, and it's not uncommon for a patient to present weeks or months later. The extensor function to the thumb can be restored, however, by transferring a tendon that extends the index finger, the extensor indices propius (EIP)-----to the EPL, distal to the site of the rupture. The pointer finger has 2 tendons, which is why this transfer is possible. After surgery, immobilization for a few weeks is required to allow the tendon connection to heal, but the functional outcome is typically very favorable.
This injury can be overlooked acutely, and it's not uncommon for a patient to present weeks or months later. The extensor function to the thumb can be restored, however, by transferring a tendon that extends the index finger, the extensor indices propius (EIP)-----to the EPL, distal to the site of the rupture. The pointer finger has 2 tendons, which is why this transfer is possible. After surgery, immobilization for a few weeks is required to allow the tendon connection to heal, but the functional outcome is typically very favorable.
