Brachioradialis Muscle Tendon Transposition in Extensor Pollicis Longus Reconstruction: Anatomical Study and a New Surgical Approach

Abstract

Background Complete extension of the thumb and activation of the extensor pollicis longus (EPL) tendon are fundamental to ensure maximum function. Many EPL repair techniques are described in the literature. Methods The authors present an alternative technique using the brachioradialis (BR) tendon. Thirty patients with injuries of the EPL tendon in zone 8 were studied. In all cases, neither direct suture repair nor traditional tendon transfer was possible. Results Thumb extension was restored in all patients with satisfactory extension recovery. All patients achieved excellent extension; good functional results were observed in 2 cases, and in 1 case satisfactory results were achieved using the Geldmacher assessment and the Kapandji assessment. The overall results were rated as excellent, good, fair, or poor according to the Quick Disabilities of the Arm, Shoulder, and Hand Scale. Discussion The BR tendon was suitable to treat all cases, in particular injuries occurring near Lister’s tubercle, due to its appropriate length for tenorrhaphy albeit with a short distal head.