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Over the proximal phalanx.
Epl tendon injury. Zone iv vii extensor tendon repair immediate controlled active motion icam. This is rarely significant and usually improves with scar massage. Volar thermoplastic splint for epl tendon repair. Yoke orthosis links the uninjured fingers to the repaired finger.
Wound infections occur in less than 1 of cases and usually quickly resolve with antibiotics. Are there any risks. Extensor pollicis longus epl is a tendon which runs on the back side of the wrist and is confined to a tight tunnel. Zones of extensor tendon injuries.
Extensor tendons are just under the skin. They lie next to the bone on the back of the hands and fingers and straighten the wrist fingers and thumb figure 1. They can be injured by a minor cut or jamming a finger which may cause the thin tendons to rip from their attachment to bone. 5 7 with the increasing use of volar plates for distal radius fractures there are new possibilities for injury and rupture of the epl in addition to previously reported etiologies.
In this area it is confined to a tight tunnel. The uninjured fingers in orthosis dynamically assist finger extension that unloads the tendon repair. An extensor tendon injury is a cut or tear to one of the extensor tendons. The tendon runs around a bony prominence on the back of the wrist called listers tubercle.
1 at the level of the distal radius the epl tendon is located just ulnar to listers tubercle within the 3rd dorsal compartment of the wrist and is. Zone ii disruption of tendon over middle phalanx or proximal phalanx of thumb epl zone iii. The tendon transfer can become a little too loose so that the thumb does not completely. 135 912 14 the two commonly accepted etiologies of epl rupture after distal radius fractures are mechanical insults or vascular insults to the tendon.
In human anatomy the extensor pollicis longus muscle epl is a skeletal muscle located dorsally on the forearmit is much larger than the extensor pollicis brevis the origin of which it partly covers and acts to stretch the thumb together with this muscle. Zone i disruption of terminal extensor tendon distal to or at the dip joint of the fingers and ip joint of the thumb epl mallet finger. The scar may be tender. This tendon straightens the end joint of the thumb and also helps pull the thumb in towards the index finger.
Extensor pollicis longus epl rupture after distal radius fractures is a well recognized problem 47 91112 14 occurring in 007 to 088 of patients. Due to this injury there is an inability to fully and forcefully extend the wrist andor fingers. If not treated an extensor tendon injury may make it hard to straighten one or more joints.
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