I fell and fractured my wrist - a minimally displaced fx of distal radius. 3 wks after the injury, while in a cast, I noticed that I could not extend the distal joint of my thumb. I thought it was just stiffness due to the cast and the swelling. At my orthopod appt 2 wks later I mentioned it to my doctor. He knew it was an EPL tendon rupture and promptly repaired it by transposition of the IPL tendon. That was 4 mos ago. With physical therapy I have regained partial extension of the thumb. I can extend the distal joint only when my thumb is folded across my palm. I cannot do the "thumb's up" sign. With my palm flat on a table I cannot lift my thumb off the table at all. It would be good enough function for most people but I am an eye surgeon. The mild limitation of thumb movement becomes significant when doing microsurgery. I can operate but I have to go much more slowly. I can tell my thumb is a bit clumsy. I have been dropping instruments. I want to know if there is any procedure that could be performed at this late date to improve my thumb extension. Could the new tendon to my thumb be shortened a bit? Is there any possible way the original EPL tendon could be found and reattached to my thumb with a tendon graft?