Extensor pollicis longus (EPL) tendon rupture results in substantial impairment of thumb function. Transfer of the extensor indicis proprius (EIP) tendon is the standard reconstructive method. Although the clinical efficacy of this procedure is well documented, the effect of cadaveric rehearsal on operative performance has not been systematically investigated. This study included 21 patients who underwent EIP-to-EPL tendon transfer and 21 cadaveric hands in which the identical procedure was performed. Demographic characteristics, rupture etiology, operative times, suturing techniques, and technical proficiency were analyzed. Technical success in the cadaveric series was evaluated using a structured five-point checklist.
The patient cohort (12 women, 9 men; mean age, 44.2 ± 12.8 years) primarily presented with traumatic EPL ruptures (76.2%). Mean operative time was significantly shorter in the cadaveric group compared with the patient group (36.2 ± 5.4 vs. 48.5 ± 8.2 minutes; p < 0.001). A distinct learning curve was observed in the cadaveric procedures. The mean operative time significantly decreased from 42.1 ± 5.4 minutes in the initial seven cases to 31.5 ± 5.4 minutes in the last seven cases (p = 0.003). The Pulvertaft weave was the predominant suturing technique (85.7% of patients, 100% of cadaveric specimens). Technical success scores in cadaveric dissections were high (mean, 4.8 ± 0.4), with 90.4% achieving a perfect score. No intraoperative complications were encountered in either group. Cadaveric rehearsal is associated with a reduction in operative time in EIP-to-EPL tendon transfer. Structured simulation provides a controlled environment to standardize surgical steps and address anatomical variations. Incorporation of cadaver-based training into surgical curricula may shorten the learning curve and improve surgical efficiency.
