Flexor Digitorum Superficialis Tendon Transfer for Intrinsic Replacement

1992 ◽  
Vol 17 (6) ◽  
pp. 625-628 ◽  
Author(s):  
J. W. BRANDSMA ◽  
M. W. OTTENHOFF-DE JONGE
Keyword(s):  
Tendon Transfer ◽  
Flexion Contracture ◽  
Flexor Digitorum Superficialis ◽  
Finger Flexion ◽  
Hand Deformity ◽  
Flexor Digitorum ◽  
Swan Neck Deformity

This study is a review of 127 hands in 100 patients in whom one or two FDS tendons were used to correct claw-hand deformity and/or loss of opposition of the thumb. In lumbrical replacement the results were graded as excellent in 16 hands (21%) and good in 43 hands (57%). For opponensplasty the results were excellent in 26 hands (32%) and good in 42 hands (51%). Possible defects that can develop in the donor finger are: swan-neck deformity, flexion posture of the DIP joint, not as part of the swan-neck deformity, check-rein deformity or flexion contracture, and insufficient finger flexion. Of the 158 fingers swan-neck deformity was seen in 15%, DIP flexion in 29%, check-rein deformity in 26% and insufficient finger flexion in 18%. The latter occurred with another defect. In 48 fingers (30%) no defects were observed.

TREATMENT OF CONGENITAL SWAN NECK DEFORMITY WITH DYNAMIC TENODESIS OF PROXIMAL INTERPHALANGEAL JOINT

2001 ◽  
Vol 26 (2) ◽  
pp. 165-167 ◽  
Author(s):  
V. SMRÈKA ◽  
I. DYLEVSKÝ
Keyword(s):  
Tendon Transfer ◽  
Tendon Graft ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Superficialis ◽  
Middle Phalanx ◽  
Flexor Digitorum ◽  
Swan Neck Deformity

Congenital swan neck deformities in seven fingers of two patients were treated by transfer of the flexor digitorum superficialis tendon to a tendon graft which was attached the extensor aponeurosis over the middle phalanx. The tendon transfer is protected for at least 2 months by a modified Murphy splint.

Influence of the flexor digitorum superficialis tendon transfer on grip strength

2021 ◽  
pp. 175319342110612
Author(s):  
Angelina Garkisch ◽  
Stefanie Schmitt ◽  
Nicole Kim ◽  
Dagmar-C. Fischer ◽  
Karl-Josef Prommersberger ◽  
...  
Keyword(s):  
Grip Strength ◽  
Tendon Transfer ◽  
Ring Finger ◽  
Flexor Digitorum Superficialis ◽  
Force Transmission ◽  
Finger Forces ◽  
Middle Ring ◽  
Flexor Digitorum

The flexor digitorum superficialis tendon of the ring finger can be transferred to the thumb flexor. We followed ten patients after such a transfer for 5–128 months and measured grip strength and force transmission of the fingers and individual phalanges while the patients gripped 10-cm or 20-cm diameter cylinders. The grip strength of the middle, ring and little fingers was reduced when gripping the 10-cm cylinder, with a significantly larger decrease in the ring finger. With the 20-cm cylinder, grip forces of all fingers were almost identical, with slightly lower force of the ring finger and slightly higher forces in the index and small fingers. We conclude that after transfer of flexor digitorum superficialis tendon from a ring finger, grip strength of the ring finger is reduced. Finger forces are more hampered while gripping objects with smaller circumferences than large ones.

Correction of Swan Neck Deformity in Rheumatoid Arthritis Using a New Lateral Extensor Band Technique

2008 ◽  
Vol 33 (6) ◽  
pp. 712-716 ◽  
Author(s):  
M. SIROTAKOVA ◽  
A. FIGUS ◽  
P. JARRETT ◽  
A. MISHRA ◽  
D. ELLIOT
Keyword(s):  
Flexor Digitorum Superficialis ◽  
Palmar Plate ◽  
Pip Joint ◽  
Distal Interphalangeal ◽  
Distally Based ◽  
Student’S T ◽  
Flexor Digitorum ◽  
Swan Neck Deformity ◽  
Student’S T Test

Swan neck deformity is a progressive and disabling condition that commonly affects rheumatoid arthritic hands. During a 4-year period, 101 fingers in 43 patients had this deformity corrected using a new procedure combining the distally based extensor lateral band technique described by Littler and the flexor digitorum superficialis (FDS)-palmar plate pulley introduced by Zancolli. The ranges of motion of the metacarpophalangeal, proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints were assessed pre-operatively and 12 months after surgery. An average PIP joint hyperextension of −13.3° was converted to +13.4°. The ranges of motion of the proximal and DIP joints were significantly different (Student’s t-test). No patient suffered recurrence of the deformity during an average follow-up of 20 months. This new technique improves some unappealing aspects of previous techniques and provides a stable and reliable correction of swan neck deformity.

Flexor digitorum profundus with or without flexor digitorum superficialis tendon repair in acute Zone 2B injuries

2020 ◽  
Vol 45 (10) ◽  
pp. 1034-1044
Author(s):  
Ahmed F. Sadek
Keyword(s):  
Tendon Repair ◽  
Flexion Contracture ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Level Of Evidence ◽  
Power Grip ◽  
Contralateral Hand ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A total of 53 patients with complete cuts of two flexor tendons in Zone 2B treated over a 9-year period was reviewed. Twenty-three patients (28 fingers) had only flexor digitorum profundus repair, while 30 patients (36 fingers) had both flexor digitorum profundus and flexor digitorum superficialis repairs, with a mean follow-up of 21 months (range 12–84). The decision to repair the flexor digitorum superficialis was made according to intraoperative judgement of ease of repair and gliding of the flexor digitorum profundus tendon. Two groups of patients showed no significant differences in total range of active or passive digital motion and power grip percentage to the contralateral hand. However, the values of power grip were statistically superior in the patients with both tendons repaired. The patients after flexor digitorum profundus-only repairs showed significantly greater but still mild flexion contracture (mean 20 °) of the operated digits. The Tang gradings were the same with 89% good and excellent rates in both groups. The conclusion is that although repair of both flexor digitorum profundus and flexor digitorum superficialis tendons is slightly more preferable based on increased grip strength, the repair of the flexor digitorum superficialis together with flexor digitorum profundus is not mandatory. Whether or not to repair flexor digitorum superficialis is an intraoperative decision based on the ease of gliding of the repaired tendon(s). Level of evidence: III

scholarly journals Quantitative examination of isolated finger flexion associated with function of the flexor digitorum superficialis

2020 ◽  
Vol 32 (11) ◽  
pp. 748-753
Author(s):  
Yudai Watanabe ◽  
Rikiya Shirato, ◽  
Takuro Wada ◽  
Kousuke Iba ◽  
Tomoko Sonoda ◽  
...  
Keyword(s):  
Flexor Digitorum Superficialis ◽  
Finger Flexion ◽  
Quantitative Examination ◽  
Flexor Digitorum

One in Four Flexor Digitorum Superficialis Lasso for Correction of the Claw Deformity.

1986 ◽  
Vol 11 (3) ◽  
pp. 404-406
Author(s):  
ATUL SHAH
Keyword(s):  
The Other ◽  
Flexor Digitorum Superficialis ◽  
Power Grip ◽  
One Stage ◽  
Flexor Digitorum ◽  
Swan Neck Deformity ◽  
A1 Pulley

In continuation of the author’s work on ‘lasso’ principle, flexor digitorum superficialis split in to four tails and looped around A1 pulley has been described in this article to correct the ulnar claw and to correct the total claw hand when used along with opponensplasty as a one stage technique. This operation has the advantage of retaining superficialis tendons of the other fingers for better power grip and the avoiding swan neck deformity.

scholarly journals Brachioradialis to flexor digitorum profundus tendon transfer to restore finger flexion

2018 ◽  
Vol 51 (02) ◽  
pp. 123-130 ◽  
Author(s):  
R. Srikanth ◽  
Koteswara Rao Rayidi ◽  
Subha Kakumanu
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Tendon Transfer ◽  
Hand Function ◽  
Flexor Digitorum Profundus ◽  
Tendon Transfers ◽  
Wrist Extensor ◽  
Nerve Transfers ◽  
Finger Flexion ◽  
Flexor Digitorum

ABSTRACT 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. BR to FDP transfer provides reasonable flexion range and an acceptable hand function to permit activities of daily living, when associated with ancillary procedures like opponensplasty, PIPJ arthrodesis. Materials and Methods: Eleven patients underwent a BR to FDP tendon transfer between January 2013 and January 2017 of which eight patients came for follow-up. Results: Four of the eight patients got a functionally useful hand to carry out activities of daily living with hook grip, span grasp, key pinch, chuck grip and pulp pinch. These patients also underwent simultaneous or secondary ancillary procedures. Four of the patients need secondary procedures to further improve functionality of the hand inspite of having a flexion range. Conclusion: The BR is an effective donor in providing adequate range and power of finger flexion in lower plexus injuries.

Flexor Digitorum Superficialis Tendon Sling Volar Plate Reconstruction for Swan-Neck Deformity in the Spastic Finger

2017 ◽  
Vol 22 (02) ◽  
pp. 251-254
Author(s):  
Y.L. Tan ◽  
F.C. Yong
Keyword(s):  
Tendon Graft ◽  
Proximal Interphalangeal Joint ◽  
Volar Plate ◽  
Safe Procedure ◽  
Flexor Digitorum Superficialis ◽  
Reconstruction Procedure ◽  
Sling Procedure ◽  
Flexor Digitorum ◽  
Plate Reconstruction ◽  
Swan Neck Deformity

The condition of proximal interphalangeal joint (PIPJ) locking in hyperextension may occur in the athetoid or spastic hand with moderate or severe swan-neck deformity at the ‘opening’ phase of prehension. The patient’s complaints are of complete or incomplete locking that may require passive assistance to initiate PIPJ flexion. Surgical procedures to overcome this include rerouting the lateral band, stabilisation or reconstruction procedure for the volar instability of the PIPJ, etc. Volar stabilisation may be achieved by Flexor digitorum superficialis (FDS) tenodesis procedures or criss-cross tendon graft for volar plate reconstruction. We report a case of successful stabilisation using the criss-cross tendon sling procedure for volar plate reconstruction using a slip of the FDS tendon instead of a free tendon graft. This is a simple and safe procedure that effectively corrects the swan-neck deformity and improves the prehension function in the hand.

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