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Finger flexor tendon

Ahmed M Hashem, Rebecca W Knackstedt, Steven Bernard, Mark Hendrickson, Jennifer M McBride, Risal Djohan
We studied anomalies of the common digital arteries by dissecting 33 fresh cadaver hands under magnification. In the majority of the dissected hands (25 hands), common digital arteries took off from the superficial palmar arch and ran superficial and parallel to the flexor tendons. Variations were found in eight out of 33 hands. In four hands the common digital artery to the second web space was replaced by an atypical vessel, originating from the deep palmar arch, that crossed posterior to the index flexor tendons proximal to the A1 pulley...
January 1, 2018: Journal of Hand Surgery, European Volume
Lisa Reissner, Nadja Zechmann-Mueller, Holger Jan Klein, Maurizio Calcagni, Thomas Giesen
We report sonographic findings with clinical outcomes after zone 2 flexor digitorum profundus tendon repairs in ten fingers. The tendons underwent a six-strand M-Tang core repair, no circumferential suture, and partial or complete division of the pulleys. Over 12 months after surgery and using ultrasound, we found no gapping at the repair site during finger motion. When the pulleys were divided, there was sonographic evidence of tendon bowstringing, but the bowstringing was minimal. Clinically, we did not find any fingers that displayed tendon bowstringing or had functional loss...
January 1, 2018: Journal of Hand Surgery, European Volume
Ilaria Tinazzi, Dennis McGonagle, Alen Zabotti, Donatella Chessa, Antonio Marchetta, Pierluigi Macchioni
OBJECTIVES: To determine whether a detailed sonographic evaluation of the hand flexor tendon compartment could help differentiate between psoriatic arthritis (PsA) and rheumatoid arthritis (RA). METHODS: Thirty-seven patients with PsA, 47 with RA and 10 healthy controls (HC) had flexor tendon (FT) compartment imaging of the dominant hand 2nd to 4th tendons using grey scale (GS) and power Doppler (PD) ultrasound (US) with evaluation for tenosynovitis, peri-tendinous lesions, soft tissue oedema and bony changes at FT insertions...
February 28, 2018: Clinical and Experimental Rheumatology
Mitsuhiko Nanno, Norie Kodera, Yuji Tomori, Shinro Takai
INTRODUCTION: The purpose of this study was to compare the movement of the flexor pollicis longus (FPL) tendon on the distal radius during wrist and finger motions before and after removal of a volar plate in patients with distal radius fractures using transverse ultrasound and to evaluate the kinematic effects on the FPL by the removal. METHODS: Twenty-five patients with distal radius fracture were evaluated quantitatively by transverse ultrasound using coordinates for the movement of the FPL on the distal radius during wrist and finger motions before and after the plate removal...
January 2018: Journal of Orthopaedic Surgery
Tao Wang, Gang Zhao, Yong-Jun Rui, Jing-Yi Mi
RATIONALE: Primary tuberculous infection in hand and wrist is a rare disease. Few articles reported on hand primary tuberculous synovitis. PATIENT CONCERNS: A 68-year-old Chinese male, without history of tuberculosis (TB), had complained of pain and swelling in right palm and little finger for 3 months. Patient came to our hospital on 9th Oct 2016. X-ray just showed soft tissue swelling in little finger. Magnetic resonance imaging (MRI) showed synovitis around flexor tendon of little finger, volar palm, and carpal tunnel...
February 2018: Medicine (Baltimore)
Haroldo Junior Fiorini, Marcel Jun Tamaoki, Mário Lenza, Joao Baptista Gomes Dos Santos, Flávio Faloppa, Joao Carlos Belloti
BACKGROUND: Trigger finger is a common clinical disorder, characterised by pain and catching as the patient flexes and extends digits because of disproportion between the diameter of flexor tendons and the A1 pulley. The treatment approach may include non-surgical or surgical treatments. Currently there is no consensus about the best surgical treatment approach (open, percutaneous or endoscopic approaches). OBJECTIVES: To evaluate the effectiveness and safety of different methods of surgical treatment for trigger finger (open, percutaneous or endoscopic approaches) in adults at any stage of the disease...
February 20, 2018: Cochrane Database of Systematic Reviews
Thomas Giesen, Lisa Reissner, Inga Besmens, Olga Politikou, Maurizio Calcagni
We report outcomes in 29 patients with flexor tendon repairs in 32 digits (five thumbs and 27 fingers) with our modified protocols. We repaired the lacerated flexor digitorum profundus tendons with core suture repairs using the 6-strand M-Tang method and without circumferential sutures. We divided the pulleys as much as needed to allow excursion of the repaired tendons, including complete division of the A4 or A2 pulleys when necessary. In nine fingers, we repaired one slip of the flexor digitorum superficialis tendon and resected the other half...
January 1, 2018: Journal of Hand Surgery, European Volume
K Yammine, M Erić
Agenesis, functional deficiency and the common type of the flexor digitorum superficialis of the little finger are reported in the literature to be highly variable with significant discrepancy between clinical and cadaveric frequencies. The aim of this systematic review was to generate overall clinical and cadaveric weighted frequencies, along with ancestry-based, side-based, sex-based and laterality-based frequencies. A systematic literature search identified 34 studies including 12,213 forearms/hands that met the inclusion criteria...
February 12, 2018: Hand Surgery and Rehabilitation
A Vidoni, M Shrivastava, Rajesh Botchu
Carpal tunnel syndrome (CTS) represents the most common entrapment neuropathy of the upper extremity. Intermittent CTS has been reported in the surgical literature and usually, related to masses associated to flexor tendons. We describe a patient with an intrasynovial lipoma involving the deep flexor of the middle finger causing intermittent CTS and snapping on flexion-extension.
February 10, 2018: Journal of Ultrasound
Laphatrada Yurasakpong, Krai Meemon, Athikhun Suwannakhan
PURPOSE: The aim of the study was to investigate the anatomy and histology of Linburg-Comstock variation, or the anomalous connection between flexor pollicis longus and flexor digitorum profundus to the index finger, in Thai population. METHODS: One hundred and thirty cadaveric upper limbs were dissected. Skin and superficial fascia on the anterior distal forearm and hand were removed. The tendons of the flexor pollicis longus and flexor digitorum profundus to the index finger were identified for the possible occurrence of the intertendinous connection...
February 8, 2018: Surgical and Radiologic Anatomy: SRA
Scott F M Duncan, Ryosuke Kakinoki, Ross Dunbar
Numerous surgical approaches have been described for treating patients suffering with stenosing tenosynovitis. The usual surgical descriptions differ mainly by the type of skin incision utilized. The goal of surgery is to completely release the A1 pulley, thereby allowing unimpeded motion of the flexor tendons. We describe a minimally invasive endoscopic technique to address this condition in the fingers.
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Kazufumi Sano, Yosuke Akiyama, Satoru Ozeki
Asymptomatic pisotriquetral arthroses caused ruptures of the flexor digitorum profundus tendon of the little finger in 2 elderly patients. Ruptures occurred with unnoticeable onset, and bilateral ruptures separately occurred with interval of several years in one patient. The tendon was ruptured in zone IV with perforation of the gliding floor through which the degenerative pisiform was visible. The gliding floor was repaired followed with excision of the pisiform, and the ruptured tendon was then transferred to the profundus tendon of the ring finger...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Takuma Wakasugi, Ritsuro Shirasaka, Toshiyuki Kawauchi, Koji Fujita, Atsushi Okawa
BACKGROUND: Intramedullary fixation for distal radius fractures is reported to be free of hardware irritation and less invasive than other fixation methods. Some specific complications associated with intramedullary fixation, such as radial nerve sensory neuritis, have been reported, but no study has focused on the complication rates of intramedullary fixation for distal radius fractures in the elderly population. Furthermore, no studies have analyzed common complications, such as carpal tunnel syndrome and flexor tenosynovitis including trigger finger, among patients with distal radius fractures treated by intramedullary fixation based on a comprehensive complication checklist...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
Lasse Linnanmäki, Harry Göransson, Jouni Havulinna, Petteri Sippola, Teemu Karjalainen, Olli V Leppänen
PURPOSE: Substantial gap formation of a repaired finger flexor tendon is assumed to be harmful for tendon healing. The purpose of this study was to investigate the relationship between gap formation and the failure of the repair during cyclic loading. METHODS: Thirty-five porcine flexor tendons were repaired and tested cyclically using variable forces until failure or a maximum of 500 cycles. Depending on the biomechanical behavior during cyclic testing, specimens were divided into 3 groups: Sustained (no failure), Fatigued (failure after 50 cycles), and Disrupted (failure before 50 cycles)...
January 23, 2018: Journal of Hand Surgery
Kyle D Lineberry, Shirley Shue, Kyle J Chepla
BACKGROUND: Penetrating trauma or lacerations within zone II of the flexor sheath may result in partial tendon injury. The proper management of this injury is controversial; the literature contains differing indications for surgical treatment and post-operative rehabilitation. METHODS: A literature review of the Cochrane, Medline and Pubmed databases was performed using the following search criteria: partial, flexor, tendon, laceration. All English language studies that evaluated biomechanical strength, complications, and outcomes after partial tendon injury in human and animal studies were included and reviewed by two of the authors...
January 12, 2018: Plastic and Reconstructive Surgery
Y M Shen, C X Ma, F J Qin, C Zhang, C Wang, X H Hu
Objective: To explore the methods and effects of wound repair and functional reconstruction of high-voltage electrical burns in wrists. Methods: From January 2009 to June 2016, 71 patients with high-voltage electrical burns in wrists were hospitalized, with 118 wrist wounds including 21 of type Ⅰ, 69 of type Ⅱ, 9 of type Ⅲ, and 19 of type Ⅳ. According to the wrist injuries, different surgical operations were performed. Forearm amputation was conducted in 20 wrists with necrosis in the distal end. On the basis of fasciotomy for decompression, early debridement was performed on the other 98 wrist wounds...
December 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Michael Howard Baca-Atlas, Amir Homayoun Barzin
A 66-year-old man with a history of renal transplant on chronic immunosuppression presented to his primary care physician with a swollen right index finger. On examination, mild swelling was present. Conservative management failed and initial plain films were negative. Corticosteroid injection was performed by orthopaedics, but symptoms recurred several months later and an MRI showed flexor digitorum tenosynovitis and abscesses of the superficialis and profundus tendons. A flexor tenolysis was performed with cultures positive for Mycobacterium szulgai, a rare, non-tuberculous mycobacterial infection...
December 22, 2017: BMJ Case Reports
A Duprat, L-E Gayet, C Breque, M Freslon
Tendon grafts are a component of the therapeutic arsenal for managing chronic flexor tendons injuries in the hand, especially during two-stage Hunter reconstruction. The purpose of this anatomical study was to compare the strength of the Pulvertaft weave versus the step-cut suture used for flexor tendon reconstruction to determine their role in early active mobilization. We performed a biomechanical study with cadaver specimens. Thirty-four hands were randomized and the tendons from both hands were equally assigned to each group...
February 2018: Hand Surgery and Rehabilitation
Nathalie van Beek, Kaj Gijsbertse, Ruud W Selles, Chris L de Korte, DirkJan H E J Veeger, Dick F Stegeman, Huub Maas
In the human hand, independent movement control of individual fingers is limited. One potential cause for this is mechanical connections between the tendons and muscle bellies corresponding to the different fingers. The aim of this study was to determine the tendon displacement of the flexor digitorum superficialis (FDS) of both the instructed and the neighboring, non-instructed fingers during single finger flexion movements. In nine healthy subjects (age 22-29 years), instructed and non-instructed FDS finger tendon displacement of the index, middle and ring finger was measured using 2D ultrasound analyzed with speckle tracking software in two conditions: active flexion of all finger joints with all fingers free to move and active flexion while the non-instructed fingers were restricted...
January 23, 2018: Journal of Biomechanics
Frédéric A Schuind, Fabian Moungondo, Pierre Van Wetter
Paradoxical finger extension is the classical clinical presentation of the lumbrical plus syndrome. We report a new additional sign, increased metacarpophalangeal flexion of the involved finger when the patient tries to make a fist. Three cases of lumbrical tightness are discussed, illustrating this new sign in 3 different clinical settings. The new sign was present in all 3 cases. Lumbrical tenotomy corrected the paradoxical interphalangeal extension and partly the increased metacarpophalangeal flexion. The lumbrical tendon has a relatively high moment arm relative to the metacarpophalangeal joint, which could explain the basis of this clinical sign...
December 6, 2017: Journal of Hand Surgery
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