Question:I am a professional oboe player in a large symphony orchestra. While we were traveling overseas, I fell and broke my wrist. My wrist is healed but my thumb is not. One of the extensor tendons in my thumb ruptured. I didn't know it until the cast was taken off. If I have surgery to repair the tendon, will I get my full motion back?
Answer:Rehab of hand injuries can be long and difficult. This is especially true for a musician who needs very fine movements. If you ruptured a tendon, a tendon transfer may be needed.
The surgeon may use one of several possible tendons in the hand to restore motion and function. For example, transfer of the extensor indicis proprius (EIP) is common to repair a ruptured extensor pollicis longus (EPL). However, using the (EIP) may decrease the strength of extension in the index finger.
This means you may be unable to lift the index finger away from the oboe. The problem is called an extensor lag. Patients can lose up to half their extensor motion after receiving an EIP transfer.
It's best to let your surgeon know of your need for finger dexterity and strength. Other tendons can be used that may suit your needs more closely.
A recent study reported using the accessory abductor pollicis longus (AAPL) instead of the standard EIP showed good results with very few problems. This new method of tendon transfer may be a treatment option for you.AdriÃ¡n BullÃ³n, MD, et al. Reconstruction After Chronic Extensor Pollicis Longus Ruptures. In Clinical Orthopaedics and Related Research. September 2007. Vol. 462. Pp. 93-98.
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