Isolated lost index finger extension after closed rupture of extensor indicis proprius (EIP) and extensor digitorum communis (EDC) tendon is a rare tendon injury. This pair of tendon often ruptured simultaneously, and its causes included acute closed trauma, peri-wrist fracture, and distal radius implant-related complication. Two cases were presented, along with a review of the literature relating to the mechanism, diagnosis, and management of this condition. The first case was a 68-year-old female injured by acute closed trauma to her wrist, and treated with tendon transfer and side-to-side suture to EDC to the middle finger. She had good result with mild extensor lag. The second was a 49-year-old male having distal radius implant attrition and treated with repair distal end of EIP to the proximal end of the EDC to the index finger and side-to-side suture to the middle finger. He had moderate index extension lag. Surgeons should be aware of the common injury mechanism, presentation, diagnostic modality, and appropriate treatment options in addition to careful surgical technique and surveillance during and after distal radius plate osteosynthesis. Good preoperative plan is the way to optimal clinical outcome.
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