Year 2020 Vol. 28 No 2




Maharishi Markandeshwar Medical College and Hospital Solan 1,
All India Institute of Medical Sciences Bathinda 2,
National Ilizarov Medical Research Center for Traumatology and Orthopedics
of Ministry of Healthcare 3, Kurgan,
The Russian Federation

Till now no single scheme of surgical treatment has gained wide acceptance in rupture of extensor pollicis longus tendon (EPL). The result of treatment of a patient with spontaneous rupture of EPL in IV zone by B.Boichev with ultrasonographic examination is presented in the paper. In surgical treatment we used Pulvertaft technique in transfer of tendon of m. extensor indicis proprius (EIP) to EPL. After 3 months of surgery the patient showed a full range of motions of the thumb joints and functional restoring. Ultrasonography can be considered as an accurate and cost effective diagnostic investigation in evaluation of cases with the suspected extensor pollicis longus tendon rupture and tendinosis. This case report shows that technique of EIP to EPL transfer is effective and reliable surgical option.

Keywords: extensor pollicis longus, tendon rupture, spontaneous, Pulvertaft, surgical technique
p. 233-239 of the original issue
  1. Björkman A, Jörgsholm P. Rupture of the extensor pollicis longus tendon: a study of aetiological factors. Scand J Plast Reconstr Surg Hand Surg. 2004;38(1):32-35. doi: 10.1080/02844310310013046
  2. Baitinger VF, Kamolov FF. Experience of surgical treatment of subcutaneous tendon damage long extensor of the thumb. Vopr Rekonstrukt i Plast Khirurgii. 2015;18(3):12-17 age=arc hive&id=1352&article_id=24683 (In Russ.)
  3. Kim CH. Spontaneous rupture of the extensor pollicis longus tendon. Arch Plast Surg. 2012 Nov;39(6):680-82. Published online 2012 Nov 14. doi: 10.5999/aps.2012.39.6.680
  4. Boichev B, Kholevich Ia, red. Khirurgiia kisti i paltsev [Elektronnyi resurs]. Sofiia: Meditsina i fizkultura; 1971. 316 p. (In Russ.)
  5. Maffulli N, Wong J, Almekinders LC. Types and epidemiology of tendinopathy. Clin Sports Med. 2003 Oct;22(4):675-92. doi: 10.1016/S0278-5919(03)00004-8
  6. Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy. 1998 Nov-Dec;14(8):840-43. doi: 10.1016/S0749-8063(98)70021-0
  7. Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-17. doi: 10.3822/ijtmb.v5i1.153
  8. De Maeseneer M, Marcelis S, Osteaux M, Jager T, Machiels F, Van Roy P. Sonography of a rupture of the tendon of the extensor pollicis longus muscle: initial clinical experience and correlation with findings at cadaveric dissection. AJR Am J Roentgenol. 2005 Jan;184(1):175-79. doi: 10.2214/ajr.184.1.01840175
  9. Low CK, Pereira BP, Chao VT. Optimum tensioning position for extensor indicis to extensor pollicis longus transfer. Clin Orthop Relat Res. 2001 Jul;(388):225-32. doi: 10.1097/00003086-200107000-00031
  10. Jung SW, Kim CK, Ahn BW, Kim DH, Kang SH, Kang SS. Standard versus over-tensioning in the transfer of extensor indicis proprius to extensor pollicis longus for chronic rupture of the thumb extensor. J Plast Reconstr Aesthet Surg. 2014 Jul;67(7):979-85. doi: 10.1016/j.bjps.2014.03.006
  11. Lee JH, Cho YJ, Chung DW. A New Method to Control Tendon Tension in the Transfer of Extensor Indicis Proprius to Extensor Pollicis Longus Rupture. Ann Plast Surg. 2015 Dec;75(6):607-9. doi: 10.1097/SAP.0000000000000593
  12. Jain A, Goyal N, Mishra P. Spontaneous rupture of EPL and ECRB tendons in a washerwoman: an unusual phenomenon. Hand Surg. 2014;19(2):241-44. doi: 10.1142/S0218810414720186
  13. Zinger G, Dalu KA, Bregman A, Yudkevich G. Spontaneous Rupture of the Extensor Pollicis Longus Tendon With Repair and Contralateral Prophylactic Decompression: A Case Report and Review of the Literature. J Hand Surg Am. 2019 Aug;44(8):702.e1-702.e5. doi: 10.1016/j.jhsa.2018.09.011
  14. Hu CH, Fufa D, Hsu CC, Lin YT, Lin CH. Revisiting spontaneous rupture of the extensor pollicis longus tendon: eight cases without identifiable predisposing factor. Hand (NY). 2015 Dec;10(4):726-31. doi: 10.1007/s11552-015-9746-y
  15. Taş S, Balta S, Benlier E. Spontaneous rupture of the extensor pollicis longus tendon due to unusual etiology. Balkan Med J. 2014 Mar;31(1):105-106. doi: 10.5152/balkanmedj.2013.9027
  16. Magnussen RA, Dunn WR, Thomson AB. Nonoperative treatment of midportion Achilles tendinopathy: a systematic review. Clin J Sport Med. 2009 Jan;19(1):54-64. doi: 10.1097/JSM.0b013e31818ef090
  17. Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clin Orthop Relat Res. 2008 Jul;466(7):1539-54. doi: 10.1007/s11999-008-0260-1
Address for correspondence:
640014, Russian Federation,
Kurgan, ul. M. Ulyanova, 6,
Russian Ilizarov Scientific
Center for Restorative
Traumatology and Orthopedics,
6th traumatologic-orthopaedic department,
mob. +7 905 8516338,
Sergey S. Leonchuk
Information about the authors:
Tiwari Punit, Orthopedic Traumatologist, Assistant Professor,Orthopedics Department, Solan city, Himachal Pradesh state, India.
Harmeet Kaur, Radiologist, Assistant Professor, Department of Radial Diagnosis, All India Institute of Medical Sciences, Bathinda city, Punjab state, India
Leonchuk Sergey S., PhD, Head of the 6th Orthopedic department, National Ilizarov Medical Research Center for Traumatology and Orthopedics of Ministry of Healthcare, Kurgan, Russian Federation.
Contacts | ©Vitebsk State Medical University, 2007-2023