“I-P Flexor Lag” after Thumb Flexor Reconstruction — Causes and Solution

HAND ◽  
1980 ◽  
Vol os-12 (2) ◽  
pp. 167-172 ◽  
Author(s):  
David B. Apfelberg ◽  
Morton R. Maser ◽  
Harvey Lash ◽  
Leo Keoshian
Keyword(s):  
Range Of Motion ◽  
Flexor Pollicis Longus ◽  
Reconstructive Procedures ◽  
Significant Percentage ◽  
Longus Tendon ◽  
Flexor Pollicis Longus Tendon

A small but significant percentage of thumbs fail to regain complete range of motion after reconstructive procedures designed to replace lost function of the flexor pollicis longus tendon. A characteristic but little noted posture and attitude of metacarpophalangeal flexion with loss of interphalangeal motion and metacarpophalangeal stabilisation with restoration of interphalangeal motion is described. (“I-P flexion lag”—I.P.F.L.) Clinical causes include shortening of the muscle-tendon unit, loss of pulleys with bowstringing, adhesions and hypermobile joints.

scholarly journals Six-Strand Flexor Pollicis Longus Tendon Repairs With and Without Circumferential Sutures: A Multicenter Study

Hand ◽  
2022 ◽  
pp. 155894472110572
Author(s):  
Géraldine Lautenbach ◽  
Marco Guidi ◽  
Bernadette Tobler-Ammann ◽  
Vera Beckmann-Fries ◽  
Elisabeth Oberfeld ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Tendon Repair ◽  
Suture Technique ◽  
Flexor Pollicis Longus ◽  
Postoperative Rehabilitation ◽  
Active Motion ◽  
Treatment Groups ◽  
Longus Tendon ◽  
Outcome Measurements ◽  
Flexor Pollicis Longus Tendon

Background: The purpose of this study is to assess outcomes in flexor pollicis longus tendon repairs with 6-strand core sutures with and without circumferential sutures. Methods: A 6-strand core suture technique with and without circumferential sutures was used. Thirty-three patients were summarized in the C group (circumferential group) and 16 patients in the NC group (non-circumferential group). After the surgery, the wrist was stabilized with a dorsal blocking splint and a controlled early active motion protocol was applied. At weeks 6, 13, and 26 data on demographics, type of injury, surgery, postoperative rehabilitation, complications such as re-rupture and the following outcome measurements were collected: range of motion and its recovery according to the Tang criteria, Kapandji score, thumb and hand strengths, Disabilities of the Arm, Shoulder and Hand score, and satisfaction. Results: There were no significant differences in range of motion and strength between the 2 treatment groups. In both groups, the outcome measurements increased over time and they expressed similar satisfaction with the surgical treatment. In 4 patients of the C group tendon repair ruptured and in 1 patient of the NC group. Conclusions: Six-strand repair technique is an effective procedure to assure early active motion after flexor pollicis longus tendon injuries and good results can also be achieved by omitting the circumferential suture.

Flexor Pollicis Longus Tendon Ruptures after Palmar Plate Fixation of Fractures of the Distal Radius

2009 ◽  
Vol 34 (4) ◽  
pp. 471-474 ◽  
Author(s):  
J. A. CASALETTO ◽  
D. MACHIN ◽  
R. LEUNG ◽  
D. J. BROWN
Keyword(s):  
Standard Treatment ◽  
Plate Fixation ◽  
Flexor Pollicis Longus ◽  
Distal Radial Fractures ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Palmar Plate ◽  
Tendon Ruptures ◽  
Flexor Pollicis Longus Tendon ◽  
Palmar Plate Fixation

Palmar plate fixation of distal radial fractures is becoming a standard treatment for this common injury. Ruptures of the extensor pollicis longus tendon have been reported in 8.6% of cases after this procedure. Although palmar plate fixation has also been associated with flexor pollicis longus (FPL) tendon problems, the majority of reported cases pre-date the use of newer anatomically precontoured locking plates. In this paper seven cases of FPL rupture are presented. This complication does not appear to be unique to one type of implant. The possible aetiologies for FPL ruptures are discussed and ways to reduce the incidence of this complication are suggested.

Limitation of Thumb Flexion Due to an Unusual Insertion of the Flexor Pollicis Longus

1988 ◽  
Vol 13 (4) ◽  
pp. 474-476
Author(s):  
H. J. HAGAN ◽  
R. S. IDLER
Keyword(s):  
Differential Diagnosis ◽  
Carpal Tunnel ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Active Flexion ◽  
Caucasian Race ◽  
Familial Relationship ◽  
Anomalous Insertion ◽  
Flexor Pollicis Longus Tendon

A case is described in which an anomalous insertion of the flexor pollicis longus tendon into the region of the carpal tunnel caused limited active flexion of the thumb in a child. This is the first reported case of this anomaly in which an apparent familial relationship has been noted, and the first reported case in the Caucasian race. Two similar cases in Japanese have been described. Abnormal insertion of a portion of the flexor pollicis longus must be included in the differential diagnosis of inadequate thumb flexion.

Scaphoid nonunion and flexor pollicis longus tendon rupture

1999 ◽  
Vol 24 (6) ◽  
pp. 1211-1219 ◽  
Author(s):  
Satoru Saitoh ◽  
Yukihiko Hata ◽  
Narimichi Murakami ◽  
Yukio Nakatsuchi ◽  
Hiroshi Seki ◽  
...  
Keyword(s):  
Tendon Rupture ◽  
Scaphoid Nonunion ◽  
Flexor Pollicis Longus ◽  
Longus Tendon ◽  
Flexor Pollicis Longus Tendon
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