Bifascicular nature of the flexor digitorum profundus and flexor pollicis longus tendons: forgotten anatomical characteristics rediscovered with US imaging

2020 ◽  
Vol 30 (12) ◽  
pp. 6653-6662
Author(s):  
Franck Lapegue ◽  
Maxence Tiercelin ◽  
Mahdi Siala ◽  
Aymeric Andre ◽  
Michel Rongieres ◽  
...  
Keyword(s):  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Anatomical Characteristics ◽  
Flexor Digitorum

Brachioradialis Transfer for Digital Palsy

1990 ◽  
Vol 15 (3) ◽  
pp. 312-316
Author(s):  
J. M. FAILLA ◽  
C. A. PEIMER ◽  
F. S. SHERWIN
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Pinch Grip ◽  
The Common ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Tendon Excursion

Although brachioradialis tendon transfer is thought to offer limited tendon excursion and finger motion, we have used it to restore active thumb and digital function in eight patients. Three had Volkmann’s contracture, one avulsion of forearm muscles and four had tetraplegia resulting in inability to perform activities of daily living and loss of pinch or grasp and extrinsic extension. The brachioradialis was transferred to the flexor pollicis longus, to the flexor digitorum profundus or to the common digital extensors. Except for one patient who had unremitting pain, all were pleased with their improved motion, pinch, grip, and independence. Function, however, remained abnormal in all but one.

LINBURG-COMSTOCK PHENOMENON FOLLOWING FOREARM LACERATION

Hand Surgery ◽  
2012 ◽  
Vol 17 (02) ◽  
pp. 221-224 ◽  
Author(s):  
B. Lin ◽  
S. Sreedharan ◽  
Andrew Y. H. Chin
Keyword(s):  
Index Finger ◽  
Interphalangeal Joint ◽  
Penetrating Injury ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Right ◽  
Flexor Digitorum ◽  
Wide Awake

A 20-year-old man presented with an inability to flex the interphalangeal joint of the right thumb without simultaneous flexion of the distal interphalangeal joint of the index finger following a penetrating injury to the right forearm. With a clinical suspicion of intertendinous adhesions between the flexor pollicis longus and the flexor digitorum profundus to the index finger, surgical exploration under wide-awake anesthesia was performed. Intraoperatively, the intertendinous adhesions were identified and divided completely. Postoperatively, the patient achieved good, independent flexion of the interphalangeal joint of the thumb. This case demonstrates a clinical picture similar to that of Linburg-Comstock syndrome, which occurred following a forearm penetrating injury. We call this the Linburg-Comstock (LC) phenomenon.

Neurotization as an alternative for restoring finger and wrist extension

2001 ◽  
Vol 94 (5) ◽  
pp. 795-798 ◽  
Author(s):  
Mehmet Erkan Üstün ◽  
Tunç Cevat Öğün ◽  
Mustafa Büyükmumcu
Keyword(s):  
Median Nerve ◽  
Motor Nerve ◽  
Flexor Digitorum Profundus ◽  
Posterior Interosseous Nerve ◽  
Flexor Pollicis Longus ◽  
Pronator Quadratus ◽  
Content Type ◽  
Pronator Teres ◽  
Flexor Digitorum ◽  
Fine Print

Object. In cases of irreparable injuries to the radial nerve or in cases in which nerves are repaired with little anticipation of restoration of function, tendon transfers are widely used. In this study, the authors searched for a more natural alternative for selectively restoring function, with the aid of a motor nerve transfer. Methods. Ten arms from five cadavers were used in the study. The posterior interosseous nerve and the median nerve together with their motor branches were exposed in the proximal forearm. The possibility of posterior interosseous nerve neurotization via the median nerve through its motor branches leading to the pronator teres, flexor pollicis longus, flexor digitorum profundus, and pronator quadratus muscles was investigated. The lengths of the nerves from points of divergence and their widths were measured using calipers, and the means with standard deviations of all nerves were calculated. Motor branches to the pronator teres, flexor pollicis longus, and pronator quadratus muscles were found to be suitable for neurotization of the posterior interosseous nerve at different levels and in various combinations. The motor nerve extending to the flexor digitorum profundus muscle was too short to use for transfer. Conclusions. These results offer a suitable alternative to tendon transfer for restoring finger and wrist extension in cases of irreversible radial palsy. The second step would be clinical verification in appropriate cases.

scholarly journals Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer's muscles)

1997 ◽  
Vol 191 (3) ◽  
pp. 451-455 ◽  
Author(s):  
M. JONES ◽  
P. H. ABRAHAMS ◽  
J. R. SANUDO ◽  
M. CAMPILLO
Keyword(s):  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Flexor Digitorum

LINBURG-COMSTOCK SYNDROME: A CASE REPORT

Hand Surgery ◽  
2012 ◽  
Vol 17 (02) ◽  
pp. 217-220 ◽  
Author(s):  
Kayoko Furukawa ◽  
Kunitaka Menuki ◽  
Akinori Sakai ◽  
Toshihisa Oshige ◽  
Toshitaka Nakamura
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
High Resolution ◽  
Index Finger ◽  
Three Dimensions ◽  
Flexor Digitorum Profundus ◽  
Distal Forearm ◽  
Flexor Pollicis Longus ◽  
Present Patient ◽  
Flexor Digitorum

We report a case of Linburg-Comstock syndrome, which is characterized with anomalous tendon slips connecting flexor pollicis longus (FPL) to the flexor digitorum profundus (FDP), usually at the index finger. The present patient started to be a carpenter and was suffering from his disability of flexing the thumb and the index finger independently when he handled the screws in his work. We surgically removed the tendinous connection of the FPL tendon and the index FDP tendon. After surgery, he could work as a carpenter without any difficulty. Surgical disconnection was effective treatment. Dynamic high-resolution ultrasound and three dimensions of computed tomography of the left distal forearm were helpful to confirm the diagnosis.

POST-TRAUMATIC COMBINED FLEXION OF THE THUMB, INDEX AND MIDDLE FINGER AFTER INTRINSIC MUSCLES RECONSTRUCTION OF THE HAND: A CASE REPORT

Hand Surgery ◽  
2011 ◽  
Vol 16 (02) ◽  
pp. 189-191 ◽  
Author(s):  
Stefano Lucchina ◽  
Alexandru Nistor ◽  
Cesare Fusetti
Keyword(s):  
Middle Finger ◽  
Surgical Reconstruction ◽  
Flexor Digitorum Profundus ◽  
Resonance Imaging ◽  
Flexor Pollicis Longus ◽  
Post Traumatic ◽  
Magnetic Resonance Imaging Mri ◽  
Flexor Digitorum ◽  
Intrinsic Muscles ◽  
Early Functional Recovery

We report a case in which simultaneous flexion of the thumb, index and middle finger occurred 6 months after the surgical reconstruction of the adductor (AM) and first dorsal interosseous (IO) muscles. An anomalous connection in the form of tendon slip associated to fibrous adhesions between the flexor pollicis longus (FPL) tendon, flexor digitorum profundus indicis (FDPI) and middle finger (FDPM) tendons were found. Either ultrasound (US) examination or magnetic resonance imaging (MRI) were unable to detect the site of adhesion. Excision of the slip and radical tenosynoviectomy led to early functional recovery.

Transfer of the Distal Terminal Motor Branch of the Extensor Carpi Radialis Brevis to the Nerve of the Flexor Pollicis Longus

Neurosurgery ◽  
2011 ◽  
Vol 70 (4) ◽  
pp. 1011-1016 ◽  
Author(s):  
Jayme Augusto Bertelli ◽  
Vera Lúcia Mendes Lehm ◽  
Cristiano Paulo Tacca ◽  
Elisa Cristiana Winkelmann Duarte ◽  
Marcos Flávio Ghizoni ◽  
...  
Keyword(s):  
Tendon Graft ◽  
Flexor Digitorum Profundus ◽  
Orthopedic Procedures ◽  
Flexor Pollicis Longus ◽  
Motor Branch ◽  
Nerve Transfers ◽  
Finger Flexion ◽  
Distal Branch ◽  
Flexor Digitorum ◽  
Extensor Carpi Radialis

Abstract BACKGROUND: In tetraplegics, thumb and finger motion traditionally has been reconstructed via orthopedic procedures. Although rarely used, nerve transfers are a viable method for reconstruction in tetraplegia. OBJECTIVE: To investigate the anatomic feasibility of transferring the distal branch of the extensor carpi radialis brevis (ECRB) to the flexor pollicis longus (FPL) nerve and to report our first clinical case. METHODS: We studied the motor branch of the ECRB and FPL in 14 cadaveric upper limbs. Subsequently, a 24-year-old tetraplegic man with preserved motion in his shoulder, elbow, wrist, and finger extension, but paralysis of thumb and finger flexion underwent surgery. Seven months after trauma, we transferred the brachialis muscle with a tendon graft to the flexor digitorum profundus. The distal nerve of the ECRB was transferred to the FPL nerve. RESULTS: The branch to the ECRB entered the muscle in its anterior and proximal third. After sending out a first collateral, the nerve runs for 2.4 cm alongside the muscle and bifurcates intramuscularly. A main branch from the anterior interosseous nerve, which entered the muscle 3 cm from its origin on the radius, innervated the FPL. The ECRB and FPL nerves had similar diameters (∼1 mm) and numbers of myelinated fibers (∼180). In our patient, 14 months after surgery, pinching and grasping were restored and measured 2 and 8 kg strength, respectively. CONCLUSION: Transfer of the ECRB distal branch to the FPL is a viable option to reconstruct thumb flexion.

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