Tensile load on the flexor digitorum profundus tendon during palmar and lateral blocking exercises: Influence on blocking force and distal interphalangeal joint flexion angle

2020 ◽  
Author(s):  
Yukihiro Osanami ◽  
Mitsuhiro Aoki ◽  
Rikiya Shirato ◽  
Yuki Saito ◽  
Egi Hidaka ◽  
...  
Keyword(s):  
Tensile Load ◽  
Interphalangeal Joint ◽  
Flexion Angle ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

The Morbidity of the Button-over-Nail Technique for Zone 1 Flexor Tendon Repairs. Should we still be using this Technique?

2008 ◽  
Vol 33 (5) ◽  
pp. 566-570 ◽  
Author(s):  
N. KANG ◽  
D. MARSH ◽  
D. DEWAR
Keyword(s):  
Flexor Tendon ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Close Attention ◽  
The Core ◽  
Joint Infections ◽  
Distal Interphalangeal ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

The button-over-nail technique is commonly used to fix the core suture to the distal phalanx for flexor digitorum profundus repairs in zone 1. We report a retrospective study of 23 consecutive patients who had a repair of the flexor digitorum profundus tendon in zone 1 using the button-over-nail technique. Fifteen patients experienced a complication, of which ten were directly related to the button-over-nail technique. Complications included nail deformities, fixed flexion deformities of the distal interphalangeal joint, infections and prolonged hypersensitivity. Two patients required amputation of the fingertip. We recommend that the button-over-nail technique should be avoided or used only with caution and with close attention to the details of the technique.

Accessory Roles of the Vinculum Breve of the Flexor Digitorum Profundus and Check-Rein Ligaments at the Distal Interphalangeal Joint

1991 ◽  
Vol 16 (3) ◽  
pp. 305-310 ◽  
Author(s):  
EMMA FLINDALL ◽  
D. A. McGROUTHER
Keyword(s):  
Interphalangeal Joint ◽  
Volar Plate ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

The vinculum breve of the flexor digitorum profundus tendon was found to apply traction to the volar plate on flexion of the distal interphanageal joint. It was also observed that the check-rein ligaments of the joint only became taut in the hyperextended position. This may account for the greater amount of passive hyperextension that can be achieved at the distal than the proximal interphanageal joint.

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.

scholarly journals Infiltration of synovitis into the flexor tendon: a case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093618
Author(s):  
Qianjun Jin ◽  
Haiying Zhou ◽  
Hui Lu
Keyword(s):  
Flexor Tendon ◽  
Surgical Excision ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexion Angle ◽  
Flexor Digitorum Profundus ◽  
Normal Tendon ◽  
Active Flexion ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

Synovitis is a type of aseptic inflammation that occurs within joints or surrounding tendons. No previous reports have described a hypertrophic synovium eroding the tendon sheath and manifesting as synovitis within the flexor tendon. We herein report a case involving a 10-year-old girl who presented to our hospital with a 1-month history of a swollen mass and progressive inability to completely flex her left index finger. The active flexion angle of the proximal interphalangeal joint was limited to 85°. A longitudinal incision of the flexor digitorum profundus tendon was surgically performed. The synovium inside and outside the flexor digitorum profundus tendon was completely removed. After the surgical excision, normal tendon gliding returned without recurrence by the 1-year follow-up. The active flexion angle of the proximal interphalangeal joint improved to 100°. To the best of our knowledge, this is the first case of synovitis affecting the flexor tendon and leading to limited flexion of a finger. The manifestation of a double ring sign on magnetic resonance imaging is quite characteristic. Early diagnosis and monitoring of the hyperproliferation and invasiveness of the synovial tissue are required. Surgical excision can be a simple and effective tool when necessary.

Miniplate Fixation for Avulsion Injuries of the Flexor Digitorum Profundus Insertion

2003 ◽  
Vol 28 (4) ◽  
pp. 363-368 ◽  
Author(s):  
N. KANG ◽  
A. PRATT ◽  
N. BURR
Keyword(s):  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Bony Union ◽  
Distal Interphalangeal Joint ◽  
Type Iii ◽  
Type Iv ◽  
Distal Interphalangeal ◽  
Joint Congruity ◽  
Flexor Digitorum ◽  
Tendon Avulsion

This article describes the use of a miniplate and cortical screws in the treatment of five cases of flexor digitorum profundus (FDP) tendon avulsion. One case was type II, three cases were type III and one case was type IV. Near normal joint congruity was restored together with bony union in all cases. Six months after surgery four cases had near normal range of motion at the distal interphalangeal joint compared with the contralateral uninjured finger. These four patients were to return to their previous activities without restriction by 3 months. One repair of a type III avulsion ruptured but the distal interphalangeal joint was pain free and stable and the patient declined further surgery. Miniplate fixation offers some advantages over existing methods of repair and adds to the range of techniques available for reattachment of the FDP tendon in these injuries.

A2 PULLEY INTEGRITY AND THE STRENGTH OF FLEXOR TENDON REPAIR: A BIOMECHANICAL STUDY IN A CHICKEN MODEL

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 11-17 ◽  
Author(s):  
Marc J. Langbart ◽  
Constantine M. Glezos ◽  
Belinda J. Smith ◽  
Elizabeth C. Clarke ◽  
Richard D. Lawson ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Flexor Tendon Repair ◽  
Pull Out ◽  
A2 Pulley ◽  
Distal Interphalangeal ◽  
Joint Flexion

Purpose: This study assesses the influence of A2 pulley integrity on the strength of the repair. Method: Part 1- The flexor digitorum profundus (FDP) tendons of 72 Cobb chicken feet were severed and repaired in the region of the A2 pulley using a modified Kessler core suture and an epitendinous suture. The A2 pulley was either left intact, divided for 50% of its length, or divided in its entirety. The distal interphalangeal joint was fixed at a position of 20°, 40° or 60° of joint flexion. The load to failure, integrity of the A2 pulley and the site of tendon failure were analysed. Part 2- A further 32 chicken feet were used to exclude the effects of freezing and thawing on results and to analyse differences when using a core suture only. Results: No difference in failure load between any of the test groups or subgroups was identified. The integrity of the A2 pulley was preserved in all specimens. The most common cause of failure was distal suture pull-out. Discussion: This study does not demonstrate that release of the A2 pulley provides an advantage in increasing tendon repair strength. Division of 50% of the A2 pulley does not predispose to pulley rupture. Flexor tendon repair strength did not alter with distal interphalangeal joint flexion between 20° and 60°. Clinical Relevance: The findings of this study do not support division of the A2 pulley to prevent flexor tendon repair failure if repair methods of appropriate strength are utilised.

A Modified Kleinert Controlled Mobilization Splint Following Flexor Tendon Repair

1984 ◽  
Vol 9 (2) ◽  
pp. 217-218 ◽  
Author(s):  
P. G. SLATTERY ◽  
D. A. McGROUTHER
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Tendon Repair ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Normal Range ◽  
Flexor Tendon Repair ◽  
Distal Interphalangeal ◽  
Flexor Digitorum

The Controlled Mobilization Splint as described by Kleinert for use following flexor tendon repair has been modified to more closely simulate the normal range of motion of the fingers and in particular to increase the range of motion at the distal interphalangeal joint and so enhance the relative gliding of the flexor digitorum superficialis and flexor digitorum profundus tendons and hence possibly to reduce potential intertendinous adhesions.

Postburn Nailfold Retraction: A Reconstructive Technique

1986 ◽  
Vol 11 (3) ◽  
pp. 385-387
Author(s):  
R. C. K. NGIM ◽  
K. SOIN
Keyword(s):  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Transposition Flap ◽  
Left Thumb ◽  
Nail Deformity ◽  
Distal Interphalangeal ◽  
Joint Flexion ◽  
Reconstructive Technique

Postburn nailfold retraction often results in nail deformity and loss of distal interphalangeal joint flexion. A technique of reconstruction of the nailfold using a proximally based transposition flap is described in a patient with postburn nailfold retraction of the left thumb, index and middle fingers.

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