Spontaneous Rupture of the Extensor Pollicis Longus Tendon in Console Video Game Players: A Case Series

INTRODUCTION: Extensor pollicis longus (EPL) tendon spontaneous rupture has been related to numerous risk factors including wrist fractures, rheumatoid arthritis, and steroids administered locally or systemically, as well as repetitive and excessive wrist motion. CASE REPORT: Four cases of spontaneous rupture of the EPL tendon, diagnosed clinically, in console video game players, were reported by the authors. None of the patients had a predisposing factor. Intraoperatively, the rupture of the EPL tendon was observed at the level of the extensor retinaculum. The ruptured tendon was repaired using a conventional extensor indicis proprius to EPL tendon transplant. At the last follow-up, 2 years following surgery, the patients had satisfactory full extension of the thumb. CONCLUSION: This series reported the spontaneous rupture of the EPL tendon without underlying chronic inflammation or bony abnormalities. It is hypothesized that chronic repetitive movements weaken the tendon leading to rupture. The possibility that playing video games can decrease pain sensation evokes concerns regarding overuse.