Flexor hallucis longus. Strengthening the extensor hallucis brevis tendon Extensor tendon of the 1st toe

The dorsal muscles are located at the top of the foot (Fig. 10.39). The interosseous muscles, which occupy the space between the metatarsal bones, are also classified as dorsal muscles, since they are very easy to reach from the top of the foot. Treating dorsal and interosseous muscles is quite simple. The pain from trigger points in them is local in nature and is not transmitted to other places.

Extensor digitorum brevis and interosseous muscles

The extensor digitorum brevis tendons lie beneath the extensor digitorum longus tendons at the top of the foot. Both sets of extensors work together to lift your toes off the ground with every step you take.

Between the metatarsal bones there are two groups of interosseous muscles - dorsal and plantar. The third group of small muscles is worm-shaped - parallel to the metatarsals on the sole, but not located between them. The interosseous muscles allow the fingers to move from side to side and are involved in their flexion and extension. This mass of small muscles may seem insignificant, but they play a large role in maintaining the balance of the body and adapting the feet to the ground. Their function is to restrain excess movement of the larger, but less sensitive muscles of the foot.

Symptoms

Pain from trigger points in the short extensors occurs directly aroundthese muscles that are located on top of the foot on its outside(Fig. 1 0.39). In the figure, the extensor quadrilateral muscle consists of three muscle heads adjacent to the four fingers. Extensor brevis thumb- the only muscle going to the big toe.

Their common zone of pain distribution coincides with the area of its distribution from extensor digitorum longus, tibialis anterior and third peroneal muscles. Sometimes you have to look at all those muscles to find the trigger points that are causing pain. One woman would have suffered with her legs for the rest of her life if she had not come across some new information.

Pain from trigger points in the interosseous musclesfelt at the base of the toes, often moving to the tips of the fingers (Fig. 10.40). In some cases, the pain involves the entire back of the foot and moves up to the front of the lower leg (not shown). Trigger points in the interosseous muscles often cause cramping and swelling on the dorsum of the foot. A dull, aching pain at the top of the foot can come from any of the dorsal plantaris muscles. Trigger points in the first dorsal interosseous muscle can cause tingling in the big toe. There is numbness rather than pain in any of the areas.

Causes

Excessive, intense walking, running, or climbing can promote trigger points in any of the interosseous muscles or any extensor muscles.
It is not uncommon to have points in all of these muscles, as they all depend on each other in this delicately balanced system of foot function. Be careful if your shoes feel too tight on the top of your feet. Tight shoes cut off circulation and interfere with movement, causing problems with the interosseous muscles and short extensor digitorum muscles. It's a good idea to avoid wearing high heels because they cause your feet to roll down to your toes and all the muscles gather in front of your feet. On the other hand, if you are not used to walking barefoot, this can also negatively affect your muscles, causing them to strain unnecessarily.

Treatment

Identify the location of the short extensor digitorum muscles by their contraction when you lift your toes (Fig. 1 0.41). To massage the dorsal muscles, use only your fingertips or thumb with weights.
These muscles are usually small and thin and do not require much pressure. To massage the interosseous muscles, insert the tips of two fingers or the thumb into the space between, above or below the metatarsals (Fig. 10.42). Figures 10.43 and 10.44 show two other methods for interosseous massage. When interosseous trigger points are active, it can cause a lot of pain and even trigger cramps if you push it too hard. If you try to straighten your foot to relieve a cramp in your arch, you may experience cramps in the interosseous muscles and short extensor muscles at the top of your foot. If you are used to extending your foot, a pre-massage will reduce the risk.

The extensor pollicis longus (lat. Musculus extensor hallucis longus) is the muscle of the lower leg of the anterior group.
Lies between the front tibialis muscle(lat. M. tibialis anterior) and long extensor digitorum (lat. M. extensor digitorum). The upper two-thirds of the extensor digitorum longus are covered by these muscles.
The muscle originates from the medial surface of the middle and lower thirds of the fibula and the interosseous membrane of the leg and, moving downwards, passes into the narrow long tendon, which passes through the middle channel under the lat. retinaculum mm. extensorum inferius to the big toe. It is attached to the distal phalanx. Some of its bundles grow together with the base of the proximal phalanx.

Related concepts

Mentions in literature

extensor pollicis longus brushes Along the radial edge of the forearm it reaches the elbow fold, then rising to the outer posterior surface of the shoulder to the acromial process of the scapula and further to the seventh cervical vertebra. From this point the meridian emerges into the supraclavicular region, from where one of its branches goes deep into the body to the colon, and the second along the neck, crossing the lower jaw in front of its angle. There he makes a turn, going to the opposite side. In the nasolabial groove it intersects with an identical meridian running along the other side of the body. There are 20 points along the meridian.

2. Large intestine meridian. Paired meridian. Belongs to the Yang system. Starts from the nail bed of the index finger, runs along its radial edge, then goes between the first and second metacarpal bones and between the tendons of the short and extensor pollicis longus brushes Along the radial edge of the forearm it reaches the elbow fold, then rising to the outer posterior surface of the shoulder to the acromial process of the scapula and further to the seventh cervical vertebra. From this point the meridian enters the supraclavicular region, from where one of its branches goes deep into the body to the colon, and the second along the neck, crossing the lower jaw in front of its angle. There he makes a turn, going to the opposite side. In the nasolabial groove it intersects with an identical meridian running along the other side of the body. There are 20 points along the meridian.

Related Concepts (continued)

Pectoralis major muscle (lat. musculus pectoralis major) - large superficial muscle fan-shaped, located on the front surface of the chest. Below it is a triangular-shaped small pectoral muscle.

Pronator teres (lat. Musculus pronator teres) is the thickest and shortest muscle of the superficial layer. There are two heads in it: the large humeral head (lat. caput humerale), which starts from the medial epicondyle humerus, the medial intermuscular septum of the shoulder and fascia of the forearm, and the smaller ulnar head (lat. caput ulnare), lying under it and originating from the medial edge of the tuberosity of the ulna. Both heads form an abdomen somewhat flattened from front to back, which...

The quadriceps femoris muscle (lat. Musculus quadriceps femoris) - occupies the entire front and partly the lateral surface of the thigh. Consists of four heads.

The muscles of the upper limbs provide freedom and a wide variety of arm movements. Muscles upper limb usually divided into the following groups: 1) muscles shoulder girdle; 2) muscles of the free upper limb - shoulder, forearm and hand.

The sartorius muscle (lat. musculus sartorius) is the muscle of the anterior thigh. It is the longest muscle in the human body.

The latissimus dorsi (lat. musculus latissimus dorsi) is a superficial muscle that occupies the entire bottom part back, the upper fascicles in the initial part are covered by the trapezius muscle.

The teres minor muscle (lat. Musculus teres minor) is an elongated, somewhat rounded cord, the muscle bundles of which are located parallel to each other.

Triceps brachii (triceps; lat. musculus triceps brachii) - extensor muscle posterior group shoulder, occupies the entire back side of the shoulder, consists of three heads - long (caput longum), lateral (caput laterale) and medial (caput mediale).

The teres major muscle (lat. Musculus teres major) is flat and elongated in shape. Covered throughout the posterior section latissimus muscle back, in the outer part - the long head of the triceps brachii muscle, deltoid muscle, and in the middle section - by thin fascia.

Biceps brachii muscle (biceps, lat. musculus biceps brachii) - large muscle shoulder, is clearly visible under the skin, due to which it is widely known even among people new to anatomy.

The coracobrachial muscle (lat. Musculus coracobrachialis) is flat, covered throughout its entire length by the head of the biceps brachii muscle. The muscle starts from the apex of the coracoid process of the scapula and is attached below the middle of the medial surface of the humerus along the crest of the lesser tubercle.

The gluteus maximus muscle (lat. gluteus maximus) is the largest muscle of the three gluteal muscles, located closest to the surface. It makes up most of the shape and appearance buttocks

Foot mobility is ensured different muscles, including the short extensor of the big toe, as well as other short and long muscles. Short muscles do not leave the area of the foot itself and are attached within it. The long muscles have their base in the lower leg and are attached to the foot. Thanks to the short and long muscles, extension of both the big and other toes occurs. The foot performs an important shock-absorbing and stabilizing function. The main movements that the foot makes are flexion and extension.

Anatomy of the foot

The muscles of the foot are divided according to their position into dorsal (or dorsal) and plantar. In addition, they can be lateral and medial. If we draw a conditional midline through the human body, then those areas that are closer to this line are called medial. The areas located closer to the outer edge are called lateral. The human foot can move in many directions. The following types of limb movement are distinguished:

flexion/extension;
abduction/adduction;
pronation/supination.

The phalanges of the toes are also quite mobile. This is necessary to perform a stabilizing function and maintain balance. Their mobility is provided by the short extensor digitorum and a separate muscle related to the thumb. The extensor digitorum brevis muscle is a fairly wide and flat muscle that runs along the entire outer area of the foot. It attaches to the heel bone, then passes to the phalangeal region, where it branches into 3 tendons. In the upper part, these tendons unite with the extensor tendon of the thumb and are attached to the phalanges. This muscle is fed by the tibial artery, and innervation is provided by the peroneal nerve.

The plantar side has its own muscles, thanks to which movement of the phalanges and the foot as a whole becomes possible. These include the muscles that abduct and flex the phalanges of the legs, as well as the lumbrical and quadratus muscles.

Long muscles of the feet

The muscles involved in flexion and extension of the phalanges can also be long. At one end they are attached to the bones of the lower leg, and at the other to the phalanges of the legs. The flexor digitorum longus is attached to tibia. Teaming up with quadratus muscle, the long flexor is divided into 4 tendons, which are attached directly to the phalanges. Due to the fact that the flexor digitorum longus is attached to four phalanges at the same time, not only flexion movements become possible, but also movement in different directions.

There is also a separate muscle that is responsible for flexion thumbs on the foot. The flexor hallucis longus is attached at one end to the lower portion of the fibula and at the other end to the base of the big toe. The flexor hallucis longus is the most powerful muscle on the back of the lower leg. In addition to ensuring the movement of the phalanx, it is needed to support the arch of the foot. The flexor digitorum longus is also necessary to bend the second and third phalanges, since its tendon is partially associated with the tendons of these fingers. In addition to flexion and extension of the foot, the flexor pollicis longus muscle is also needed for supination and adduction.

Responsible for the extension of the phalanges on the legs long muscles. The extensor digitorum longus muscle is located on the outer side of the leg and is attached to a bone called the tibia. Then the extensor digitorum longus stretches along the shin and in the foot diverges into 5 branches, which are attached to the phalanges with the help of tendons. The extensor digitorum longus is involved not only in their extension, but also in extension of the limb.

Extensor hallucis longus

The extensor hallucis longus originates at the bottom of the fibula. It is attached to the base of the bones of the thumbs. The extensor pollicis longus is necessary not only for its movement, but also for the mobility of the limb.

The extensor pollicis longus also provides supination and circular movements feet

How to strengthen your feet

Strengthening these structures is important for our health. There is such a thing as a “leg core”. It includes small muscles, which are necessary to stabilize the entire body. Thanks to them, shocks when running and walking are softened, and a stable body position is maintained. If these muscles are weakened, then the entire load will be distributed on the plantar fascia, which can lead to the development of plantar fasciitis. Moreover, a weak ligamentous muscle system leads to a gradual change in gait, which can cause problems with the knees, hip joints and even the spine.

To strengthen your feet, there are simple exercises you can do at home.

Complex	Performance
Exercise No. 1.	For this exercise you will need a towel. Grab it with your toes and drag it across the room. Having reached the opposite wall of the room, use your feet to form a ball out of this towel. Then grab the fabric again and drag him to the other end of the room. Do this exercise with each foot.
Exercise No. 2.	This exercise is performed while sitting. To complete it, you will need small objects (for example, glass balls, dice, buttons). Grab an object from one pile with your feet and transfer it to another. Do the same with the other foot.
Exercise No. 3.	The exercise can be done while sitting at first. Over time, it is performed while standing on one leg. Place your foot on the floor in its normal position. Then pull your toes towards you, forming an arch with the arch of your foot.
Exercise No. 4.	Sit on the floor with your legs extended straight in front of you. Tighten your foot and arch it as if you were wearing a high-heeled shoe. Fix your leg in this tense position and slowly turn your foot towards you.

The positive effect of such home exercises occurs after 3-4 months. The main thing is not the duration of the exercises, but their regularity. After a few months, the muscles of the feet will become stronger and the arch will rise. Blood circulation will also improve and the sensitivity of the foot will increase, which is extremely important for developing stability.

Walk barefoot on grass, sand and pebbles more often, after making sure there are no foreign objects.

Foot health needs to be paid attention to Special attention. Fatigue and heaviness in the legs are perhaps the first signs that something is wrong with the legs. To prevent the development of many unpleasant diseases, it is necessary to adhere to some preventive recommendations.

Avoid the “wrong” shoes. Start by throwing away your slippers. If you feel uncomfortable barefoot, you can purchase thick sports socks. When choosing shoes for everyday wear, pay attention to the quality of the shoes and the manufacturer. Make sure that it has a fairly dense (but not “wooden” backdrop). It’s good if the insoles in shoes have special instep supports or inserts.
if you have overweight, then you will have to get rid of them. The fact is that excess weight creates an additional and constant load on the feet, as a result of which they seem to “creep apart” and sag. This can cause the development of flat feet.
To strengthen the muscles of the lower leg and feet, use a jump rope. If you have no contraindications, jumping rope will not only help make your muscles stronger, but also increase general endurance body. In addition, when jumping, plaques on the walls of blood vessels are destroyed, which has an additional positive effect.
Engage in general strengthening of the body. For this purpose, hardening, sunbathing and walking on grass or sand barefoot are suitable. Do not forget also about taking vitamin complexes, especially in the autumn-winter period.

Combination simple exercises and recommendations has a significant positive effect for the whole body. Do not neglect these recommendations and remember that regularity and consistency in their implementation are the key to your health.

The foot remains mobile due to the presence of various types of muscles in its structure, including extensor brevis big toe. Short muscles are those that do not extend beyond the foot area. The long ones are based in the ankle and attached to the foot. The most important function of these muscles is considered to be the flexion and extension of all fingers and the movement of the phalanges located on the feet.

The muscles located in the toes are responsible for performing the correct movements of the bone levers in ankle joint, and if they are damaged, the functioning of this entire department is disrupted. The structure of the foot contains short and long muscles. There are also several finger flexors: the short flexor of the foot of the little finger and other fingers. Mobility of the foot is provided by two extensor tendons.

Short muscles

The extensor digitorum brevis muscle is a wide, flat band-like muscle that runs along the outside of the foot. It is attached to the heel bone, from where it moves to the toes and there it is transformed into three tendons. At the very top they connect with other tendons, and then attach to the phalanges. The muscle is nourished with useful substances by the blood flow that moves through the tibial artery, and the supply of nerve sensitivity to these tissues is provided by the peroneal nerve.

Long muscles

The extensor hallucis longus is attached to the tibia at one end and to the phalanges at the other. Its main function: flexes the thumb and extends it. The extensor unites with the so-called quadratus muscle and is divided into four tendons. All these tendons are attached to the four phalanges on the lower extremities, which allows you to flex and extend the foot and move it in different directions. The foot is located on the side of the lower leg on its outer side and is attached to the tibia. Then it passes along the area of the lower leg and, penetrating the structure of the foot, is divided into five processes attached to the phalanges. This structure is responsible for extensions and bends lower limb, its supination and is responsible for rotational movements.

Diseases and injuries to the extensor longus are dangerous because they severely limit the mobility of the injured limb. For example, with tendinitis of the long extensor tendon, it becomes impossible to bend and straighten the fingers, gait is impaired, and this condition can lead to disability without proper treatment.

Strengthening the feet with exercise therapy

The extensor muscle of the big toe can be strengthened so that it excessive load or various diseases is not damaged. To achieve this, various physical therapeutic exercises. Such measures are considered an excellent prevention of leg pain.

There is a term called the leg core, which refers to the collection of all the small muscles and tendons that stabilize the body during activity and movement. The function of these fabrics is to reduce and absorb the shock of walking while maintaining balance throughout the body. When these muscles weaken exercise stress passes to the plantar fascia, in which pathological processes develop due to overstrain. Weakening of the ligamentous apparatus over time provokes a change in gait and becomes the root cause of pathologies in the knees and hip joints, and also causes disorders in the spine.

To strengthen the tendons and muscles of the foot, it is necessary to perform therapeutic exercises several times a week. The advantage of such physical education is that anyone can do it at home. Below are some of the exercises that help strengthen the ligamentous apparatus in the legs.

You should take the towel with your toes and stretch it across the room for several meters. Next, form a lump from this towel with your fingers. Grab the towel again and move it in the opposite direction. Repeat using the other lower limb.
Scatter small objects on the floor - buttons, small balls and sit on a chair. Now try to collect these items with your feet in some kind of box. Repeat with the other leg.
The first few times this exercise is carried out in sitting position, then standing. You should place your foot on the floor, then pull your toes towards you and at the same time form an arch with your feet.
Sit on the floor with your legs extended in front in a straight position. Now you need to tense your foot and stretch it as if you were standing in heels. Fix the position and try to slowly turn your foot towards you. Repeat several times.

Noticeable results can be seen within a few months regular classes. The muscles gradually become stronger, the arch of the foot rises. Blood circulation improves, foot sensitivity increases, and the stability of the whole body is restored.

Extensor pollicis longus injury within the terminal phalanx. This injury is no different from similar injuries to the extensor muscles of the other fingers. In the presence of damage localized proximal to the main joint, there are conditions for applying a primary tendon suture, but after 3-4 weeks, a secondary tendon suture is not feasible due to the reduction of the ends of the tendon.

To eliminate a defect free tendon transfer required or it is better to use tendon transposition. Transposition uses the common extensor tendon of the second finger, to which the distal end of the extensor pollicis tendon is sutured.

Extensor longus rupture occurs quite often. This damage is divided into the following types:
1. direct or indirect rupture caused by trauma;
2. spontaneous rupture:
a) occupational hazards,
b) tendon changes,
c) rupture due to damage to the limb.

Tendon rupture due to direct injury and the result of its treatment using the tendon transposition method are presented in the figure (own observation).

"Spontaneous" tendon ruptures due to occupational hazards were described at the end of the last century by military doctors (Zander). The left hand of army drummers, when holding a drumstick, was in a position of pronounced dorsiflexion; due to its unnatural position, tenosynovitis and tendon degeneration developed, which led to “spontaneous” rupture.

A 47-year-old bricklayer suffered a hand injury as a result of a falling log; there was no active extension of the thumb of the right hand (a).
Immediately after the injury, stitches are applied only to the skin. Transposition of the extensor tendon of the index finger was performed under conditions of scar tissue. The result of the intervention is shown in photo b

Wurtenau described 59 cases of rupture tendons from the drummers of the Prussian army. These typical ruptures are known in the literature as “Drummer’s palsy” (“Trommerlahmung” or “Drummer’s palsy”).

IN tendon ruptures have been described in the literature due to various diseases his. Thus, ruptures due to suppuration, gout, syphilis, tuberculous tendovaginitis (10 cases of Meson), gonorrhea (Melchior), polyarthritis (Lederich, Herries) and rheumatism (Vadstein).

At post-traumatic tendon rupture From the moment of injury to tendon rupture, there is a latent period lasting from several days to several years. For rupture of the extensor pollicis longus tendon after a fracture radius Linder (1885) and Geinicke (1913) first drew attention to it. Mek Master in 1932 collected only 27 similar cases from the literature.

F. Steppelmore in 1940 he wrote a general report about 148 already known cases. In 1955, G. Strandell, including his own 14 observations, reported 60 new cases of these injuries. Thus, 208 cases of post-traumatic tendon rupture are known in the literature. This type of injury predominates in women in 67-37%. In most cases, ruptures occur when the radius is dislocated or fractured without displacement of the fragments. The incidence of rupture of the extensor pollicis longus tendon, according to different authors, varies.

Frequency of this complications after Gauck radial fracture 6:100, according to Moore 3:500, according to Steppelmore 3:1000, according to Marcus 4:2134, according to Boehler 1:500.

Extensor pollicis longus begins on the dorso-radial surface of the middle third of the ulna and on the interosseous membrane. Its tendon at the level of the wrist passes in a separate tendon sheath. This space, the third dorsal tendon sheath, is essentially a bone canal. It is deeper and narrower than the sheaths of the other extensors. The tendon runs obliquely and, crossing with the long and short extensor carpi radialis, forms the ulnar edge of the “anatomist’s snuffbox”.

Extensor tendon within the proximal phalanx of the thumb it expands and attaches to the base of the distal phalanx. The main function of the extensor pollicis longus is to extend it at the terminal, main and saddle joints. In addition, this muscle promotes the retroposition of the thumb, participates in the dorsiflexion of the hand and, together with the adductor pollicis muscle, in adducting the latter. Its most important function is to fix the saddle joint.

Due to the fact that the condition for good capture is fixation muscles of the centrally located joints, loss of function of the long extensor pollicis leads to almost complete loss of grip function with the thumb.

Overwhelming most post-traumatic ruptures, long after the moment of injury, occurs not as a result of unusual efforts, but in the process of habitual daily movements. Tendon rupture in these cases is not accompanied by pain. After rupture, the thumb droops, the distal phalanx assumes a bent position and cannot be actively straightened. Retroposition and adduction of the thumb cannot be achieved. The contours of the ulnar edge of the “anatomical snuffbox” are smoothed out.

Due to the lack stabilization of the saddle joint the grip is not strong enough, so the patient is unable to use scissors, write, or fasten buttons.

Usually gap localized at the level of the distal edge of the dorsal transverse carpal ligament. Above this level, rupture occurs rarely, in approximately 7% of cases. The distal end of the tendon is palpated above the first metacarpal bone in the form of a nodule. The proximal end of the tendon contracts and moves quite far in the central direction. The tendon sheath collapses.

In a relationship pathogenesis of long extensor tendon rupture thumb, the opinions of the authors agree. The special role of the canal and the course of the tendon are emphasized. Levy and Cohen consider Lister's tubercle, which forms the radial edge of the canal, as a hypomochlion, over which the tendon lengthens and disintegrates during movement.

Significance of radius fractures for subcutaneous rupture of the extensor pollicis muscle has been studied by many authors. According to most researchers, the callus formed after a fracture of the radius narrows the tendon canal, and existing bone fragments, gradually damaging the tendon, can contribute to its rupture.

According to Rau And Weigel, in tendon rupture, the deterioration of the vascularization of the tendon over the age of 25-30 years is crucial, since in adults there are no longitudinal intratendinous vessels, and the external vascular network may suffer from various types injuries Strandell believes that the occurrence of post-traumatic tendon rupture is associated with a disruption of its blood supply due to injury (hematoma, thrombosis, degenerative changes connective tissue), and the rupture occurs at the place of least resistance, that is, within the vagina.
Complete transection of the tendon with a sharp bone fragment is suggested only in rare cases.

Treatment of post-traumatic rupture of the extensor pollicis longus tendon must always be prompt. According to their principle, operations are divided into two groups, namely: methods of direct connection of the ends of the tendon and methods of tendon transposition - connecting the distal end of the torn tendon with another extensor tendon located nearby.

Direct method tendon end connections, due to stump reduction and tendon degeneration, is now rarely used. Methods for replacing tendon defects also did not lead to satisfactory results (free tendon transfer, replacement of the defect with fascia or artificial material, etc.).

Currently it predominates tendon transposition method. This method was first used by Duplay (1876). He connected the distal end of the extensor pollicis longus to the extensor carpi radialis longus. The extensor tendons that can be used for transposition are listed in the table.

For transpositions As a rule, it is best to use a tendon whose direction of traction and amplitude of sliding do not differ from the “tendon-muscle motor” being replaced. When considering the extensor tendon from these two points of view, it turns out that the requirements are best met, firstly, by the extensor tendon of the index finger, and secondly, by the tendon of the extensor carpi radialis longus.

The first of these was first used for this purpose by Mensch (1925), and in the recent past its use was recommended by many authors (Bunnell, Pulvertaft, Christoph) and especially I. Böhler. The advantage of the extensor radialis longus is its anatomical proximity to the site of the rupture and the fact that the direction of its traction acts on the ulnar side. Given its anatomical location, this tendon is recommended for transposition by Schlatter and Fett. The disadvantage of this muscle tendon is that it has less movement than the extensor pollicis longus tendon.

Transposition of the extensor tendon of the index finger Strandell performs it as follows: the tendon of the extensor extensor propria of the index finger is intersected above the head of the second metacarpal bone through a transverse skin incision of 1 - 2 cm. The distal end of the tendon is attached to the tendon of the common extensor of the index finger so that when the finger is straightened, it provides resistance to rotation of the index finger. Within the wrist, according to the location of the tendon, a longitudinal skin incision is made, through which the cut tendon of the extensor of the index finger is removed.

Then, using new cut at the level of the middle of the first metacarpal bone, the stump of the tendon of the extensor pollicis longus is released, and then connected “end to end” with the tendon of the extensor of the index finger, carried under the skin.

Rupture of the extensor pollicis longus tendon due to a radius fracture

Case of own observation: B.I., a 28-year-old teacher, received a fracture of the radius in a typical location with slight displacement of the fragments. After reposition, four weeks of fixation, and subsequent three weeks of functional therapy following removal of the plaster cast (Fig. a), the patient felt healthy. However, in the eighth week, while cleaning the apartment, in the absence of any strong movements, the patient felt a crunch in her thumb, after which it became impossible to straighten it. A typical position of the thumb for an extensor tendon rupture is shown in Fig. b.