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extensor and flexor injury mechanism hand

Christopher L Jones, Derek G Kamper
Finger-thumb coordination is crucial to manual dexterity but remains incompletely understood, particularly following neurological injury such as stroke. While being controlled independently, the index finger and thumb especially must work in concert to perform a variety of tasks requiring lateral or palmar pinch. The impact of stroke on this functionally critical sensorimotor control during dynamic tasks has been largely unexplored. In this study, we explored finger-thumb coupling during close-open pinching motions in stroke survivors with chronic hemiparesis...
2018: Frontiers in Neurology
J Pech, D Veigl, M Vlček
A spontaneous tendon rupture is a direct consequence of rheumatoid inflammation and can appear without any noticeable impact, often during sleep. The patient then presents with inability to flex or extend metacarpophalageal or interphalangeal joints. Multiple ruptures resulting in impaired function of several fingers can also occur and markedly limit the hand's grip strength. A tear may arise from either mechanical injury to the tendon along its course over bone or connective tissues, or by biochemical action of lysosomal enzymes, released during the inflammation process, on the connective tissue of the tendon...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Mohana Amirtharajah, Lisa Lattanza
The extensor tendons in the dorsum of the hand lie relatively superficially, making open injuries to the extensor mechanism a common source of morbidity. These injuries can range from simple clean lacerations to complex open injuries associated with severe skin and soft tissue loss. Although many advances in the treatment of tendon injuries focused on the flexor tendon, the extensor tendon has begun to receive more attention in recent literature. Knowledge of modern repair techniques and rehabilitation protocols may improve patient outcomes...
February 2015: Journal of Hand Surgery
Johanna P de Jong, Jesse T Nguyen, Anne J M Sonnema, Emily C Nguyen, Peter C Amadio, Steven L Moran
BACKGROUND: Acute traumatic tendon injuries of the hand and wrist are commonly encountered in the emergency department. Despite the frequency, few studies have examined the true incidence of acute traumatic tendon injuries in the hand and wrist or compared the incidences of both extensor and flexor tendon injuries. METHODS: We performed a retrospective population-based cohort study of all acute traumatic tendon injuries of the hand and wrist in a mixed urban and rural Midwest county in the United States between 2001-2010...
June 2014: Clinics in Orthopedic Surgery
Yeoun-Seung Kang, Yoon-Ghil Park, Bum-Suk Lee, Hyung-Soon Park
The wrist-driven flexor hinge orthosis (WDFHO) is a device used to restore hand function in persons with tetraplegic spinal cord injury by furnishing three-point prehension. We assessed the effectiveness and biomechanical properties of the WDFHO in 24 persons with cervical 6 or 7 tetraplegia who have severely impaired hand function. This study introduces a mechanical operating model to assess the efficiency of the WDFHO. Experimental results showed that pinch force increased significantly (p < 0.001) after using the WDFHO and was found to positively correlate with the strength of wrist extensor muscles (r = 0...
2013: Journal of Rehabilitation Research and Development
C P Betzler, H Sorg, M A Altintas, P M Vogt
Tendon injuries of the hand are common and their treatment is surgically challenging. Precise knowledge of the anatomy of the extensor and flexor tendons in the hand is necessary to be able to perform a detailed clinical examination and to estimate adequately the extent of injury. Depending on the injury pattern, various conservative and surgical treatment options must be considered. Concerning the overall concept of the supply of tendon injuries of the hand, follow-up treatment is crucial to achieve an optimal functional outcome...
August 2013: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
E Cigna, Ö Özkan, S Mardini, P-T Chiang, C-H Yang, H-C Chen
INTRODUCTION: Spontaneous rupture of the extensor pollicis longus (EPL) tendon has been reported after trauma, rheumatoid arthritis and sports. Rupture may also occur as a consequence of the use of anabolic steroids for recreational purposes, or systemic steroids for the treatment of a variety of medical conditions. CASE REPORT: We present a case report of a woman affected with a spontaneous EPL tendon rupture resulted 14 months after a corticosteroid injection for flexor tenosynovitis, "trigger finger," of the thumb...
March 2013: European Review for Medical and Pharmacological Sciences
Sudhagar Gangatharam, Monique LeBlanc
Extensor tendon injuries are given less importance than the flexor tendon injuries; however, the extensor mechanism is more complicated than flexor tendon system, and regaining satisfactory function is a challenge. It has been reported that loss of digital flexion would affect grasp and power grip imposing greater functional loss than digital extensor lag. Zone 3 extensor tendon management is complex because of excessive scar formation limiting composite digital flexion and extension. The adhesions are more common if the tendon is immobilized for long period...
March 2013: Techniques in Hand & Upper Extremity Surgery
Xinyan Li, Xuetao Liu, Chengqi Wang, Qishen Fan
OBJECTIVE: To investigate the surgical method and effectiveness of repairing traumatic metacarpophalangeal joint defect by the composite tissue flap autograft of the second metatarsophalangeal joint. METHODS: Between June 2005 and December 2009, 6 cases (6 fingers) of traumatic metacarpophalangeal joint defect were treated with the composite tissue flap autograft of second metatarsophalangeal joint (containing extensor tendon, flexor tendon, proper digital nerve, planta or dorsal flap)...
September 2011: Chinese Journal of Reparative and Reconstructive Surgery
Yunkang Yang, Xiaobo Lu, Zhongjie Zhang, Jianhua Ge
OBJECTIVE: To evaluate the clinical efficacy of akin united flaps pedicled with dorsal carpal branch of ulnar artery in repairing complicated degloving injuries of the opposite fingers. METHODS: Between August 2005 and August 2009, 11 cases of complicated degloving injuries of single finger were treated, including 8 males and 3 females with an average age of 26 years (range, 19-55 years). The defect locations were thumb in 1 case, index finger in 7 cases, and middle finger in 3 cases, including 9 cases of mechanical injury and 2 cases of traffic accident injury...
February 2011: Chinese Journal of Reparative and Reconstructive Surgery
M Vlček, I Landor, P Višňa, P Vavřík, J Sindelářová, A Sosna
PURPOSE OF THE STUDY: Intra-articular fractures of the distal radius are treated predominantly by open reduction and internal fixation with various types of angle-stable plates. In this study we compare functional and radiographic outcomes in patients with intra-articular distal radius fractures treated with either angle-stable plates with rigid-direction screw insertion or multidirectional angle-stable plates. MATERIAL AND METHODS: The LCP group included 37 patients with an average age of 50 years (range 20-81 years) who were treated using angle-stable plates with rigid-direction screw insertion (LCP, Synthes)...
2011: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Jonas L Matzon, David J Bozentka
The extensor mechanism of the fingers, hand, wrist, and forearm is extremely intricate. Disruptions to the extensor system are common and can be associated with poor patient outcomes when not treated appropriately. Although extensor tendon injuries receive much less attention in the literature than flexor tendon injuries do, several recent studies have examined this topic. This article presents an overview of the treatment of extensor tendon injuries, with a focus on recent developments.
May 2010: Journal of Hand Surgery
Hsieh-Ching Chen, Cha-Mei Chang, Yung-Ping Liu, Chih-Yong Chen
This study utilized a portable data logger to measure the wrist angles and forearm flexor and extensor electromyography (EMG) of 21 hairstylists. The hairstylists were divided into two groups, one with 11 barbers (9 males and 2 females) specializing in men's hairdressing, and one with 10 hairdressers (2 males and 8 females) specializing in women's hairdressing. The standard haircut task was divided into three subtasks: hair cutting, washing and blow-drying. The mechanical exposures of the overall task and subtasks were quantified to compare how subtasks, occupational groups, and gender groups differ...
January 2010: Applied Ergonomics
Radha K Holavanahalli, Phala A Helm, April R Gorman, Karen J Kowalske
OBJECTIVE: To measure hand-specific functional performance after deep full-thickness dorsal hand burns. DESIGN: Descriptive, cross-sectional study. SETTING: The 2005 Phoenix Society's World Burn Congress, Baltimore, MD. PARTICIPANTS: Volunteer sample of burn survivors (N=32) with full-thickness dorsal hand burns with extensor mechanism involvement, who consented to participate. INTERVENTIONS: Not applicable...
December 2007: Archives of Physical Medicine and Rehabilitation
David A Stewart, Peter J Smitham, Mark P Gianoutsos, William R Walsh
PURPOSE: The vincula are specialized mesotendinous structures attaching to the flexor tendons of the hand. In addition to providing vascular supply to the tendons, the vincula can be mechanically important. The purpose of this study was to quantify the influence of intact vincula on digital flexion after flexor tendon laceration and to assess the ultimate strength and stiffness of the vincula. METHODS: The index, middle, and ring fingers of 12 fresh-frozen cadaveric fingers were dissected free at the level of the metacarpophalangeal joint, preserving at least 10 cm of the flexor and extensor tendons...
October 2007: Journal of Hand Surgery
Tsukasa Kanchiku, James V Lynskey, Danielle Protas, James J Abbas, Ranu Jung
Upper extremity neuromuscular electrical stimulation (FNS) has long been utilized as a neuroprosthesis to restore hand-grasp function in individuals with neurological disorders and injuries. More recently, electrical stimulation is being used as a rehabilitative therapy to tap into central nervous system plasticity. Here, we present initial development of a rodent model for neuromuscular stimulation induced forelimb movement that can be used as a platform to investigate stimulation-induced plasticity. The motor points for flexors and extensors of the shoulder, elbow, and digits were identified and implanted with custom-built stimulation electrodes...
January 30, 2008: Journal of Neuroscience Methods
Z Mascharka
Knowledge of the functional anatomy of the extensor tendons with the sliding mechanism is essential for better understanding the surgical therapy and the postoperative care in the different trauma zones of the extensor tendon. In addition the localization of the injury is very important for the clinical findings, therapy, after-care and long term prognosis. Anatomical facts, injury mechanisms and associated injuries have to be considered in the therapy concept. Several therapy possibilities are known: immobilizing with splint for the closed rupture in zone I, reinsertion in zone III (with a temporary Kirschner-wire-pinning), tendon suture, tendon transplantation or transposition...
June 2007: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
Edward A Clancy, Mark V Bertolina, Roberto Merletti, Dario Farina
The amplitude and mean power spectral frequency (MNF) of the electromyogram (EMG) of flexor digitorum superficialis and extensor carpi radialis muscles were monitored during cyclic, force-varying, constant-posture, submaximal, grip-force contractions until endurance. These contractions are reminiscent of work tasks associated with the risk of repetitive stress injuries. Based on recommendations from a prior cross-comparison study of these data, the cyclic grip-force contractions were temporally aligned cycle-by-cycle to the achieved grip force profile, then EMG amplitude was computed using signal whitening (500 ms window) and MNF was computed using the short-time Fourier transform (500 ms window)...
October 2008: Journal of Electromyography and Kinesiology
A Wanivenhaus
In the course of rheumatoid arthritis, changes to tendons occur in different areas. This can lead to rupture if not prevented at an early stage. In particular, regions with extreme joint thickness, high mechanical wear and tear and narrow regions present a higher risk of synovitis. This primarily affects the tendons of the hand, where the extensor digitorum minimus tendon and the extensor and flexor pollicis tendons are most at risk. There is a high possibility of rotator cuff lesion in the shoulder area during the course of a secondary synovitis dependent raised shoulder, or by bursitis or tendonitis...
February 2007: Zeitschrift Für Rheumatologie
Derek G Kamper, Audrey M Yasukawa, Kenley M Barrett, Deborah J Gaebler-Spira
PURPOSE: This pilot study examined the effects of neuromuscular electrical stimulation (NMES) therapy on upper limb impairment in children with cerebral palsy, specifically addressing spasticity, heightened passive resistance to wrist rotation, coactivation, and weakness. METHODS: Eight subjects, aged five to 15 years, with spastic hemiparesis subsequent to brain injury, participated in three months of NMES therapy, targeting the wrist flexor and extensor muscles...
2006: Pediatric Physical Therapy
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