Publication: A solution for EPL ruptures in pediatric forearm fractures fixed with intramedullary devices: a case series on EIP to EPL transfer
Date
2025
Journal Title
Journal ISSN
Volume Title
Publisher
Madhesh Institute of Health Sciences (MIHS)
Abstract
ABSTRACT:
Delayed rupture of the extensor pollicis longus (EPL) tendon is a rare complication following pediatric forearm fractures, particularly after intramedullary fixation. We present a series of three cases managed with extensor indicis proprius (EIP) to EPL tendon transfer, highlighting surgical outcomes. All three patients, aged between 10 and 13 years, presented with inability to extend the thumb between four to eight months after fixation of both bone forearm fractures with intramedullary devices. EPL rupture was diagnosed clinically and confirmed by ultrasonography. Surgical management involved removal of intramedullary devices and EIP to EPL tendon transfer using the Pulvertaft weave technique in a single setting. Postoperative recovery was uneventful in all patients, with restoration of thumb extension and return to normal activities. This case series underscores the importance of maintaining a high index of suspicion for EPL rupture in children with loss of thumb extension following pediatric forearm fixation with an intramedullary device and the efficacy of timely tendon transfer in restoring function.
Description
Basanta Maharjan1,*, Aayush Bajrachaya1, Shriraj Shrestha1, Pramod Bhandari1, Shefali Shrestha2
¹Department of Orthopedics, KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal
2The British College, Thapathali road, Kathmandu, Nepal