Oral Presentation NZ Association of Plastic Surgeons & NZ Society for Surgery of the Hand

Rupture of the Extensor Pollicus Longus (EPL) tendon following distal radial fractures; Management (and should EPL always be reconstructed?) (1485)

Karen Smith 1 , Julie Collis 1
  1. Middlemore Hospital, Auckland, AUCKLAND, New Zealand

Rupture of the extensive policies longus tendon (EPL) following distal radial fractures, treated conservatively or by surgery, has been variously reported as between 1 - 5%

Traditionally, this is surgically managed by the transfer of extensor indicus tendon to EPL with an expected good outcome.

However, when this complication occurs, the patient has, by then, already been  inconvenienced, either by a period of casting or surgery, and the prospect of a further operative procedure and another 2-3 months of rehabilitation is often quite daunting. 

Is treatment necessary in all cases of a ruptured EPL?

A renown concert pianist who suffered this complication, following volar plate fixation of her distal radius, elected not to have her EPL reconstructed. She achieved an excellent outcome with a return to high demand performance.

An assessment of her case will be presented as will a review of the literature, with specific reference to musicians. The general management of this complication, and the means to avoid it, will be discussed.