Extensor indicis proprius transfers for extensor pollicis longus ruptures secondary to rheumatoid arthritis

Objectives: We evaluated the results of extensor indicis proprius (EIP) to extensor pollicis longus (EPL) transfers for EPL ruptures secondary to rheumatoid arthritis. Methods: Twenty-four patients (7 males, 17 females; mean age 41 years; range 22 to 72 years) with rheumatoid arthritis underwent EIP to EPL transfer for 25 ruptures. The mean duration from rupture to surgery was 4.3 months (range 1.5 to 11 months). Functional assessment of the fingers was made using a specific EIP-EPL evalu¬ation method developed by Lemmen et al. Pinch and grip strengths were measured. Range of motion of the metacarpophalangeal and interphalangeal joints of the thumb was compared with the normal side. Patient satis¬faction was evaluated by a visual analog scale. The mean follow-up period was 6.2 years (range 4.7 to 7.9 years). Results: Functional results were perfect in 14 fingers (56%), good in six fingers (24%), moderate in four fin¬gers (16%), and poor in one finger (4%). The pinch and grip strengths were 86% and 92% of the uninvolved hand, respectively. The mean visual analog scale score was 74 (range 24 to 99). Compared to the uninvolved side, the range of motion of the thumb and index finger decreased by 23° and 7°, respectively, with a 9% loss of interpha¬langeal motion and a 17% loss of metacarpophalangeal motion in thumb extension. Independent extension of the index finger was possible in 21 hands. Conclusion: The results of EIP to EPL transfers are suc¬cessful in ruptures secondary to rheumatoid arthritis.