An alternative method to assess for EPL rupture.

摘要

Extensor pollics longus (EPL) rupture is associated with fracture of the distal radius. Rheumatoid arthritis, osteoar-thritis of the trapeziometacarpal joint, blunt trauma, infections, sports-induced injuries, giant cell tumor, and extensor carpi radialis longus avulsion fracture of the third metacarpal base are also recognized factors for EPL rupture. The incidence of EPL rupture is higher in women than in men. After the EPL rupture, the thumb is postured in flexion and the patient exhibits an obvious inability to extend the thumb interphalangeal (IP) joint (Fig. 1); the thumb loses its precision function and the patient complains of weakness in pinch and grasp. The function of EPL is to extend the IP joint and to stabilize the metacarpophalangeal (MP) joint extension of the thumb in the plane of the hand. Perhaps its major functional role is to allow the first metacarpal to rise dorsally and medially toward the index finger to facilitate pinch. Patients with EPL rapture will have difficulty in using scissors, using a computer keyboard, opening a jar, using a knife, handling money, writing, sewing, and peeling vegetables and fruits.