An Extensor Indicis Proprius Transfer for Chronic Extensor Pollicis Longus Injury After Nearly 2 Decades

Case: A 36-year-old soldier presented for foreign training fitness with a history of a fall 18 years previously, that injured his nondominant left wrist. Initially, the injury was managed conservatively with a below elbow cast. Since then, he had been unable to extend the thumb at the interphalangeal joint but adapted well to daily activities. Surgical reconstruction using an extensor indicis proprius (EIP) to extensor pollicis longus (EPL) tendon transfer yielded favorable recovery. Conclusion: This case highlights neglected EPL injury over 18 years and confirms that EIP transfer, when precisely performed, can restore thumb function such as pinch and grip even in very delayed cases.