Anatomic relationship of extensor indicis propius and extensor digitorum communis: Implications for tendon transfer

BACKGROUND The extensor indicis proprius(EIP)tendon is a frequently used donor for a variety of tendon transfers,most commonly for reconstruction of the extensor pollicis longus(EPL).EIP is known to have frequent anatomic variants including split tendons and variations in tendon arrangement.AIM To characterize the anatomy of the EIP at the level of the extensor retinaculum,where tendon harvest is often performed,and share our preferred technique for EIP to EPL transfer.METHODS Twenty-nine fresh-frozen cadaveric forearms without history of forearm or hand injury or surgery were dissected.Tendon circumference and relationship of the EIP and extensor digitorum communis to the index(EDCI)at the metacarpophalangeal(MCP)joint and the distal extensor retinaculum were recorded.Distance from the distal extensor retinaculum to the EIP myotendinous junction was measured.RESULTS EIP was ulnar to the EDCI in 96.5%of specimens(28/29)at the distal edge of the extensor retinaculum.In the remaining specimen,EIP was volar to EDCI.Tendon circumference at the distal extensor retinaculum averaged(9.3 mm±1.7 mm)for EDCI and 11.1 mm(±2.7 mm)for EIP(P=0.0010).The tendon circumference at the index MCP joint averaged 11.0 mm(±1.7 mm)for EDCI and 10.6 mm(±2.1 mm)for EIP(P=0.33).EIP had a greater circumference in 76%(22/29)of specimens at the distal extensor retinaculum whereas EIP had a greater circumference in only 31%(9/29)of specimens at the MCP joint.CONCLUSION The EIP tendon is frequently ulnar to and greater in circumference than the EDCI at the distal extensor retinaculum,which can be taken into consideration for tendon transfers involving EIP.

遇见兰卡威的碧海蓝天

很欣赏一句话：身体和灵魂,总有一个要在路上!虽然也有人说,旅行就是从一个自己待厌了的地方,去到另一个别人待厌了的地方,但对“行在路上”这种状态的享受,还是会让我不断期待下一次的出行!跟爱人旅行，选择浪漫之地；跟父母旅行，选择温馨之地；此次跟闺蜜一起旅行，我选择了风情之地——兰卡威!兰卡威是马来西亚最大的一组岛屿，由99个石灰岩岛屿组成，位于槟榔屿的北方，地理位置靠近泰国，总面积526平方公里。