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Flexor digitorum profundus

Harry Whitehouse, Jeffrey C Y Chan, Matthew James
We present a case of spontaneous closed flexor digitorum profundus (FDP) tendon rupture of the fifth finger occurring in the carpal tunnel region (Zone IV) of the hand. A review of literature illustrates that spontaneous rupture of FDP in Zone IV is extremely rare and we wish to highlight this.
2018: Case Reports in Plastic Surgery & Hand Surgery
Elizabeth M Polfer, Jennifer M Sabino, Ryan D Katz
We present an all-inside technique for zone I flexor tendon repair that combines suture anchor fixation with buried back-up fixation. The back-up fixation uses transosseous tunnels and a dorsal counterincision to allow a suture tied dorsal to the distal phalanx and buried. This technique is strong and permits early active range of motion. The dorsal tie-over does not require a suture button and, therefore, does not imperil the nail matrix. The surgical technique is herein described including the proposed anesthesia (wide awake), the incisions (midlateral), the exposures, and the repair itself...
October 8, 2018: Journal of Hand Surgery
Eliana B Saltzman, Schneider K Rancy, Darryl B Sneag, Joseph H Feinberg Md, Dale J Lange, Scott W Wolfe
BACKGROUND: Acute flaccid myelitis is associated with enterovirus D68 induced inflammation and destruction of cervical anterior horn cells. To date, no medical intervention has altered the disease course. METHODS: We report two pediatric patients who were treated with nerve transfer in three limbs with sustained upper extremity neuropathy. Postoperative outcomes included muscle strength, graded on the British Medical Research Council (BMRC) scale, range of motion, and electromyography...
August 20, 2018: Pediatric Neurology
Susumu Yoneda, Hirotaka Okubo, Stephen W Linderman, Nozomu Kusano, Matthew J Silva, Stavros Thomopoulos, Fuminori Kanaya, Richard H Gelberman
The failure rate of intrasynovial tendon repair is high due to substantial elongation at the repair site and to the development of adhesions between the tendon's surface and the surrounding digital sheath. To minimize these complications, we sought to reduce the incidence of gapping and to facilitate the initiation of early motion by improving the time zero structural properties of repair. The Winters-Gelberman 8-strand repair technique was modified by adding surface lock loops and by using Fiberwire suture material...
2018: PloS One
Kanit Sananpanich, Jirachart Kraisarin, Wuttipong Siriwittayakorn, Siam Tongprasert, Songkiet Suwansirikul
PURPOSE: To explore the feasibility of restoring all finger flexion after a cervical spinal cord injury. METHODS: Double nerve transfer was conducted in 22 cadaver upper extremities. Donor nerves were the brachialis branch of the musculocutaneous nerve and the extensor carpi radialis brevis (ECRB) branches of the radial nerve. Recipient nerves were the anterior interosseous nerve (AIN) and the flexor digitorum profundus (FDP) branch of ulnar nerve (ulnar-FDP). Nerve transfers were evaluated on 3 parameters: surgical feasibility, donor-to-recipient axon count ratio, and distance from the coaptation site to the muscle entry of recipient nerve...
October 2018: Journal of Hand Surgery
Jae-Hwi Nho, Sang-Woo Lee, Mi-Ae Nam, Byung-Sung Kim, Ki Jin Jung
Avulsion fracture of the volar base of the distal phalanx is a rare injury. Zone 1 flexor tendon injuries can be treated with either internal or external fixation techniques. Pull-out suture repairs are often used for FDP tendon avulsion injuries. However, the pull out suture technique is associated with a number of well documented complications including nail bed injury and pressure necrosis. Despite the variety of techniques available for the repair of acute distal zone 1 flexor tendon injuries, no one technique has proven to be superior to all others...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
Deepak Samson, Manish Gupta
BACKGROUND: The terminal phalanx of the fingers carries the attachment of the Flexor Digitorum Profundus (FDP) on the volar surface and the extensor on the dorsal surface. Avulsion of these tendons has traditionally been repaired with pull-through sutures. Recently, bone anchor sutures have been found to be of comparable biomechanical strength but with the added advantage of technical ease and fewer complications. However, the dimensions of the bone, at the site of insertion of the anchors, have never been studied...
September 2018: Journal of Hand Surgery Asian-Pacific Volume
M Ettinger, R Karkosch, H Horstmann, P Savov, T Calliess, T Smith, M Petri
BACKGROUND: Reliable biomechanical data about the strength of different tibial extracortical graft fixation devices is sparse. This biomechanical study compares the properties of tibial graft fixation in ACL reconstruction with either the ACL Tight Rope™ or the Rigid Loop Adjustable™ device. The hypothesis was that both fixation devices would provide comparable results concerning gap formation during cyclic loading and ultimate failure load. METHODS: Sixteen sawbone tibiae (Sawbones™) underwent extracortical fixation of porcine flexor digitorum profundus grafts for ACL reconstruction...
September 29, 2018: Journal of Experimental Orthopaedics
Mantu Jain, Chandrakanta Nayak, Barada Prasana Samal, Amit Tirpude
Fracture humerus may be associated with nerve injuries. However, among them median nerve is uncommonly involved and clinical affection of the anterior branch of median nerve is rare which can be easily missed and could be under-reported. A 42-year-old man presented with closed fracture of shaft of humerus right sided following fall. He had isolated weakness of flexor pollicis longus and flexor digitorum profundus of index finger without any other sensorimotor dysfunction. The findings were consistent with isolated palsy of anterior interosseous nerve (AIN)...
September 28, 2018: BMJ Case Reports
Edie Benedito Caetano, Luiz Angelo Vieira, João José Sabongi Neto, Maurício Benedito Ferreira Caetano, Rodrigo Guerra Sabongi
Objective: The goal of this study was to describe anatomical variations and clinical implications of anterior interosseous nerve. In complete anterior interosseous nerve palsy, the patient is unable to flex the distal phalanx of the thumb and index finger; in incomplete anterior interosseous nerve palsy, there is less axonal damage, and either the thumb or the index finger are affected. Methods: This study was based on the dissection of 50 limbs of 25 cadavers, 22 were male and three, female...
September 2018: Revista Brasileira de Ortopedia
Andrew Schannen, Samuel Cohen-Tanugi, Matthew Konigsberg, Peter Noback, Robert J Strauch
Introduction: The quadriga phenomenon results from excessive shortening of the flexor digitorum profundus (FDP) tendon to the middle, ring, or small finger. Methods: Five cadaveric specimens were used to create a model for quadriga. The FDP tendons to the middle, ring, and small fingers were shortened in 5-mm increments, and the tip-to-palm (TTP) distance of adjacent fingers was recorded. Results: Shortening of the middle finger FDP by 10 mm resulted in an average TTP distance of 6 mm in the ring finger and 5 mm in the small finger...
November 2017: Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
Paul J Choi, Chidinma Nwaogbe, Joe Iwanaga, Georgi P Georgiev, Rod J Oskouian, R Shane Tubbs
Introduction A reoperation for a cubital tunnel syndrome is not uncommon. Patients often complain of sensorimotor symptoms in the ulnar nerve distribution after their primary surgery. The documented etiologies for such a phenomenon include a "new" kinking of the distal ulnar nerve and a "new" compression of the ulnar nerve by the fascial septum in between or tendinous bands over the muscles of the forearm. The deep fascial plane along which the ulnar nerve travels in the forearm has had scant attention...
June 19, 2018: Curēus
M Le Hanneur, A Walch, T Gerosa, A Grandjean, E Masmejean, T Lafosse
We aimed to assess the rate and type of postoperative motor deficits that might be encountered following elbow flexion reanimation using ulnar- and/or median-based side-to-end nerve transfers in patients with brachial plexus injuries. All patients who underwent elbow flexion reanimation between November 2015 and October 2017 at our facility by nerve transfer based on partial harvests of the median and/or ulnar nerves were included. Postoperative clinical assessment was conducted the day after surgery to identify motor deficits in the territory of the harvested nerves...
August 2, 2018: Hand Surgery and Rehabilitation
Marion Mühldorfer-Fodor, Angela Reger, Thomas Pillukat, Thomas Mittlmeier, Jörg van Schoonhoven, Karl-Josef Prommersberger
BACKGROUND: Due to the functional coupling of adjacent finger joints and the quadriga effect of the flexor digitorum profundus an influence of the grip pattern of the hand after fusion of a distal interphalangeal joint (DIPJ) is assumed. PATIENTS AND METHODS: Two patients with DIPJ II- fusion and 8 patients with DIPJ III- fusion due to a posttraumatic osteoarthritis, but without any other pathology of both hands were assessed on average 55 (17-121) months postoperatively by manugraphy...
June 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Karl-Friedrich Schüttler, Alexander Scharm, Thomas Stein, Thomas J Heyse, Michael Lohoff, Frank Sommer, Anja Spiess-Naumann, Turgay Efe
INTRODUCTION: Although there is increasing evidence for the successful use of local vancomycin applied by soaked compresses during ACL reconstruction, there are still little data on its microbiological and biomechanical effects. Furthermore, exact dosage of vancomycin with respect to tendon stability and microbiological effectivity is still unknown. MATERIALS AND METHODS: 63 porcine flexor digitorum profundus tendons were harvested under sterile conditions from fresh cadaver legs...
July 23, 2018: Archives of Orthopaedic and Trauma Surgery
Kristopher R Karvelas, Alyson L Hommel, Michael S Cartwright, Francis O Walker, Lisa D Hobson-Webb
No abstract text is available yet for this article.
October 2018: Muscle & Nerve
Naoto Matsunaga, Koji Kaneoka
This study investigated muscle synergy during smash shot in badminton and compared synergies of advanced players (more than 7 years experience) and beginner players (less than 3 years experience). The dominant hand of all players was the right side. Muscle activities were recorded on both sides of the rectus abdominis, external oblique (EO), internal oblique/transversus abdominis (IO/TrA), and erector spinae. Additionally, the right side of the biceps brachii, triceps brachii, flexor carpi radialis, flexor carpi ulnaris, and flexor digitorum profundus muscle activities were recorded...
2018: Applied Bionics and Biomechanics
Sara Edsfeldt, Martin Eklund, Monica Wiig
STUDY DESIGN: Observational cohort study. INTRODUCTION: Investigating prognostic factors using population-based data may be used to improve functional outcome after flexor tendon injury and repair. PURPOSE OF THE STUDY: The aim of this study is to investigate the effect of concomitant nerve transection, combined flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) tendon transection and the age of the patient, on digital range of motion (ROM) more than 1 year after FDP tendon transection and repair in zone I and II...
July 5, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Gabriel Halát, Lukas L Negrin, Ewald Unger, Thomas Koch, Johannes Streicher, Jochen Erhart, Patrick Platzer, Stefan Hajdu
The purpose of this study was to determine the biomechanical characteristics of an innovative surgical technique based on a tension banding principle using a suture anchor in the repair of bony avulsions of the flexor digitorum profundus tendon. After injury simulation in 45 fresh frozen distal phalanges from human cadavers, repair was performed with minifragment screws, interosseous sutures and the innovative technique (15 per group). All repairs were loaded for a total of 500 cycles. Subsequently the specimens were loaded to failure...
July 2, 2018: Scientific Reports
Chun Bi, Andrew R Thoreson, Chunfeng Zhao
Tendon or ligament reconstructions often use autologous or allogenic tendons from either extrasynovial or intrasynovial sources. Allograft tendons must be lyophilized for preservation before transplantation, a process which can impact mechanical properties of the graft. Reconstituted graft properties that are similar to native tendon are desirable. Although tensile and compressive properties of tendons have been investigated, there is a paucity of information describing flexural properties of tendon, which can impact the gliding resistance...
June 18, 2018: Journal of Biomechanics
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