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Flexor digitorum profundus

Sarah Bond, Philippa Rust, Maria Boland
PURPOSE: Avulsion injury of the flexor digitorum profundus (FDP) tendon has been traditionally repaired with a pull-out suture over the nail plate. Complication rates with this method and improvements in anchor design have led to the increased use of bone anchors to give a rigid all-inside repair. However, the dimensions of the distal phalanx may limit their use. The primary hypothesis was that 2 micro bone anchors could fit in either perpendicular or 45° proximally angled positions within each distal phalanx...
February 15, 2019: Journal of Hand Surgery
Joanna Diong, Martin E Héroux, Simon C Gandevia, Robert D Herbert
It has been hypothesized that force can be transmitted between adjacent muscles. Intermuscle force transmission violates the assumption that muscles act in mechanical isolation, and implies that predictions from biomechanical models are in error due to mechanical interactions between muscles, but the functional relevance of intermuscle force transmission is unclear. To investigate intermuscle force transmission between human flexor pollicis longus and the index finger part of flexor digitorum profundus, we compared finger flexion force produced by passive thumb flexion after one of three conditioning protocols: passive thumb flexion-extension cycling, thumb flexion maximal voluntary contraction (MVC), and thumb extension stretch...
2019: PloS One
Kenji Goto, Kiyohito Naito, Yoichi Sugiyama, Nana Nagura, Ayaka Kaneko, Yoshiyuki Iwase, Kazuo Kaneko
BACKGROUND: The aim of this study was to assess the height of nonunion formation injuring the ulnar-side finger flexor tendon, the positional relationship between the hook of the hamate and little finger flexor tendon was evaluated on CT scans. METHODS: The subjects were 20 healthy patients (40 hands) (14 males and 6 females, mean age: 28 years old). Their hands were imaged in extension and flexion of the fingers on CT. The position of the little finger flexor tendon was determined regarding the height of the hook of the hamate as 100%...
March 2019: Journal of Hand Surgery Asian-Pacific Volume
Linden K Head, Gerald Wolff, Kirsty U Boyd
A 25-year-old man sustained a right-sided brachial plexus injury from a high-velocity motocross accident. Physical examination and electromyography were consistent with a pan-brachial plexopathy with no evidence of axonal continuity. The patient underwent a spinal accessory to suprascapular nerve transfer and an intercostal to musculocutaneous nerve transfer with interpositional sural nerve grafts. He recovered MRC 4/5 elbow flexion and MRC 2/5 shoulder abduction and external rotation. Twenty-two months post-injury the patient displayed a flicker of flexion of his flexor pollicis longus and flexor digitorum profundus to his index finger - he went on to recover a functional pinch...
March 2019: Journal of Hand Surgery Asian-Pacific Volume
David J Graham, Harry D S Clitherow, Harvinder P Singh, Elizabeth C Clarke, Belinda J Smith, Michael A Tonkin
PURPOSE: To quantify the amount and pattern of finger range of motion loss at the metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints with a simulated extensor tendon adhesion at the level of the proximal phalanx or metacarpal. METHODS: In 10 cadaveric specimens, traction sutures were placed in the forearm extensor digitorum communis and flexor digitorum profundus tendons of the middle and ring fingers. Active motion was simulated by suspending weights from the traction sutures via pulleys...
February 4, 2019: Journal of Hand Surgery
Zhang Jun Pan, Yun Fei Xu, Lei Pan, Jing Chen
We report the outcomes of zone 2 tendon repairs in 60 fingers using a strong core suture, sparse peripheral stitches and early active motion. From January 2014 to April 2016, we repaired 60 flexor digitorum profundus tendons with a tensioned 4-strand or 6-strand core suture and three to four peripheral stitches. The A2 or A4 pulleys were vented as necessary. Following early active flexion of the repaired tendons, no repairs ruptured and 52/60 (87%) fingers recovered to good or excellent function using the Tang criteria after follow-up of 8-33 months...
February 7, 2019: Journal of Hand Surgery, European Volume
Brynne Dykes, Julianna Johnson, Jun G San Juan
Flexor tendon pulley injury is associated with a change in relative activation of the flexor digitorum superficialis (FDS) and flexor digitorum profundus (FDP) muscles. The purpose of this study was to determine the effect of taping of the fingers on relative muscle activation of the FDS and FDP muscles in uninjured rock climbers. Muscle activation in 10 healthy volunteers were recorded using intramuscular electromyography (EMG) during a static hang with subjects utilizing the crimp grip without tape, with a circumferential tape and with an H-tape in random order...
January 28, 2019: Journal of Electromyography and Kinesiology
Baozhi Ding, Xin Wang, Min Yao
PURPOSE: We utilized a novel approach of combined photochemical tissue bonding (PTB) and human amniotic membrane (HAM) to improve hand tendon repair and also evaluated its efficacy. METHODS: Subei chickens underwent surgical transection of the flexor digitorum profundus tendons and repair by (1) SR (standard Kessler suture; n = 24; 6-0 prolene) and (2) HAM/PTB (n = 24), where a section of HAM was stained with 0.1% Rose Bengal, wrapped around the ruptured tendon and bonded with 532 nm light (0...
January 30, 2019: Surgical Innovation
Stephen J Wallace, Lauren M Mioton, Robert M Havey, Muturi G Muriuki, Jason H Ko
PURPOSE: Conventional suture repairs, when stressed, fail by suture rupture, knot slippage, or suture pull-through, when the suture cuts through the intervening tissue. The purpose of this study was to compare the biomechanical properties of flexor tendon repairs using a novel mesh suture with traditional suture repairs. METHODS: Sixty human cadaveric flexor digitorum profundus tendons were harvested and assigned to 1 of 3 suture repair groups: 3-0 and 4-0 braided poly-blend suture or 1-mm diameter mesh suture...
January 16, 2019: Journal of Hand Surgery
Justin W Zumsteg, Jason G Ina, Greg A Merrell
OBJECTIVES: To evaluate hand surgery fellow ultrasound (US) evaluations and performance of clinically relevant tasks after brief instruction. METHODS: Six hand surgery fellows completed an US assessment and a survey on US use before and 1 month after a 30-minute US course. RESULTS: The time to obtain an adequate image decreased from 4 minutes 42 seconds (4:42; range, 3:57-7:55) to 0:52 (range, 0:30-1:14; P < .001). Participants' performance for structure identification improved from 9...
January 16, 2019: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Kristopher R Karvelas, Ted Xiao, Carl D Langefeld, Francis O Walker, Sapna Pathak, James B Caress, Vanessa Baute, Michael S Cartwright
INTRODUCTION: Inclusion body myositis (IBM) can have clinical and electrodiagnostic features similar to other neuromuscular diseases, making it a diagnostic challenge. This prospective study was designed to determine the accuracy of forearm ultrasound for IBM. METHODS: Sixty adults were recruited (15 with IBM, 15 with amyotrophic lateral sclerosis (ALS), 15 with other myopathies, and 15 healthy controls), and each underwent ultrasound of the bilateral forearms (imaging the flexor digitorum profundus and flexor carpi ulnaris muscles)...
January 12, 2019: Muscle & Nerve
Wolfram Weschenfelder, Reinhard Friedel, Gunther O Hofmann, Mark Lenz
INTRODUCTION: Few case reports describe the development of a hematoma under oral anticoagulation as the cause of an atraumatic carpal tunnel syndrome. CASE REPORT: A 76 years old woman presented an acute atraumatic carpal tunnel syndrome of her left hand under oral anticoagulation with rivaroxaban due to atrial fibrillation. 12 years ago, palmar plate osteosynthesis of a distal radius fracture had been performed on the affected wrist. Open decompression of the carpal canal was performed due to persistent severe pain under intense pain therapy and progressive neurological symptoms...
January 10, 2019: Archives of Orthopaedic and Trauma Surgery
Malrey Lee, Young-Ran Jung, Young-Keun Lee
Secondary trigger finger caused by trauma to the hand, especially associated with partial flexor tendon rupture, is not a common condition. Thus, the clinical manifestations of these patients are not well-known. The aim of this study is to present secondary trigger finger caused by a neglected partial flexor tendon rupture including discussion of the mechanism and treatment.We retrospectively reviewed the records of 6 patients with trigger finger caused by a neglected partial flexor tendon rupture who had been treated with exploration, debridement, and repairing of the ruptured tendon from August 2010 to May 2015...
January 2019: Medicine (Baltimore)
Yuki Fujihara, Hideyuki Ota, Kentaro Watanabe
INTRODUCTION: Flexor tendon injury often occurs with concomitant injuries such as fracture, vascular injury, and extensor tendon injury. These injuries are repaired independently, without a comprehensive strategy. We aimed to identify the effect of concomitant injuries and treatment choice on the outcome of flexor tendon repair. PATIENTS AND METHODS: We evaluated 118 fingers of 102 adult patients with zone 1-3 flexor digitorum profundus (FDP) tendon injuries who underwent primary surgery at our hospital between April 2009 and December 2017...
December 2018: Injury
Nathan T Morrell
The reconstruction of chronic flexor tendon injuries remains one of the more challenging injuries facing the hand and upper extremity surgeon. In the setting of an intact flexor digitorum superficialis (FDS), there are few indications for isolated flexor digitorum profundus (FDP) reconstruction. Because of the interplay of the FDP system, the reestablishment of normal tension of the FDP tendons and lumbricals is particularly challenging, and postoperative stiffness, quadriga, or lumbrical plus phenomena can actually lead to a deterioration of digital function with surgery...
December 5, 2018: Techniques in Hand & Upper Extremity Surgery
R Srikanth, Koteswara Rao Rayidi, Subha Kakumanu
Introduction: The main deformity following an adult lower brachial plexus injury is the loss of finger flexion. Distal nerve transfers have been used to restore finger and thumb flexion followed by tendon transfers for intrinsic replacement for opening of the fingers. When patients present beyond 6 months, only tendon transfers are applicable. Since the brachioradialis (BR) is always spared in such injuries, it is the ideal muscle to provide finger flexion. Wrist extensor power may not be normal for the use of the radial wrist extensor to serve as donor...
May 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Satoshi Kamihata, Takashi Oda, Takuro Wada
We experienced a rare case of carpal tunnel syndrome and rupture of the flexor digitorum profundus tendon to the index finger with a scapholunate advanced collapse wrist. We speculated that the lunate that had extruded into the carpal tunnel compressed the median nerve and caused wear of the flexor tendon following neglected perilunate subluxation. Carpal tunnel release, opponensplasty by palmaris longus tendon transfer, and a bridge graft by a half-slip of the flexor carpi radialis tendon resulted in recovery of pinch function and improvement in numbness of the hand...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Yoke-Rung Wong, Ita Suzana Mat Jais, Min-Kai Chang, Beng-Hai Lim, Shian-Chao Tay
BACKGROUND: This study evaluated the feasibility of using a low-profile titanium (Ti) plate implant, also known as the Ti-button, for Zone II flexor tendon repair. We hypothesize that the use of the Ti-button can distribute the tensile force on the digital flexor tendons to achieve better biomechanical performance. METHODS: Twenty lacerated porcine flexor tendons were randomly divided into two groups and repaired using Ti-button or 6-strand modified Lim-Tsai technique...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Min Kai Chang, Shian Chao Tay
BACKGROUND: Although flexor tendon injuries cause significant morbidities and socio-economic implications, there have been limited data on patient demographics, injury characteristics and surgical details. The aim of this study is to describe our experience in flexor tendon injuries and repairs. METHODS: We performed a retrospective study of all digital flexor tendon injuries that were repaired from January 2011 to December 2014. The collected data included patient demographics, injury characteristics and surgical details...
December 2018: Journal of Hand Surgery Asian-Pacific Volume
Matthew J Zdilla, Paula Pacurari, Tyler J Celuck, Reed C Andrews, H Wayne Lambert
Gantzer muscles are variant muscles in the anterior forearm inserting into the flexor pollicis longus or, less often, the flexor digitorum profundus. The presence of Gantzer muscles can cause a compressive neuropathy affecting the anterior interosseous nerve (Kiloh-Nevin syndrome). These muscles must also be considered when anterior forearm fasciotomies are performed for the management of acute compartment syndrome. In this case report, a novel Gantzer muscle originated from the flexor digitorum superficialis as well as the investing fascia of the brachialis muscle; the latter site is a novel proximal attachment not previously reported...
October 31, 2018: Anatomical Science International
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