A Troublesome Flexor Tendon Anomaly

HAND ◽  
1982 ◽  
Vol os-14 (1) ◽  
pp. 51-52 ◽  
Author(s):  
D. M. Evans

An anatomical variation is described in which a connection between flexor digitorum superficialis and profundus of the ring finger led to difficulty in withdrawing the superficial tendon for transfer.

1992 ◽  
Vol 17 (6) ◽  
pp. 661-664 ◽  
Author(s):  
T. OGINO ◽  
H. KATO

In five of six cases of camptodactyly in which an abnormality of the flexor tendon was examined at operation, the flexor digitorum superficialis tendon was hypoplastic and there was no continuity of the normal tendon between the muscle belly and bony insertion. The proximal end of the flexor digitorum superficialis tendon was attached to the palmar aponeurosis and the flexor tendon sheath of the ring finger in two patients, to the palmar aponeurosis in one, to the undersurface of the transverse carpal ligament in one and to the flexor tendon sheath of the ring finger in one. The tenodesis effect of the abnormal tendon of the flexor digitorum superficialis is considered to play an important role in the cause and rapid increase of the deformity of camptodactyly.


2018 ◽  
Vol 44 (4) ◽  
pp. 354-360 ◽  
Author(s):  
Koji Moriya ◽  
Takea Yoshizu ◽  
Naoto Tsubokawa ◽  
Hiroko Narisawa ◽  
Yutaka Maki

We report seven patients requiring tenolysis after primary or delayed primary flexor tendon repair and early active mobilization out of 148 fingers of 132 consecutive patients with Zone 1 or 2 injuries from 1993 to 2017. Three fingers had Zone 2A, two Zone 2B, and two Zone 2C injuries. Two fingers underwent tenolysis at Week 4 or 6 after repair because of suspected repair rupture. The other five fingers had tenolysis 12 weeks after repair. Adhesions were moderately dense between the flexor digitorum superficialis and profundus tendons or with the pulleys. According to the Strickland and Tang criteria, the outcomes were excellent in one finger, good in four, fair in one, and poor in one. Fingers requiring tenolysis after early active motion were 5% of the 148 fingers so treated. Indications for tenolysis were to achieve a full range of active motion in the patients rated good or improvement of range of active motion of the patients rated poor or fair. Not all of our patients with poor or fair outcomes wanted to have tenolysis. Level of evidence: IV


Hand Surgery ◽  
2013 ◽  
Vol 18 (03) ◽  
pp. 375-379 ◽  
Author(s):  
Muntasir Mannan Choudhury ◽  
Shian Chao Tay

Surgical treatment for trigger finger involves division of the A1 pulley. Some surgeons perform an additional step of traction tenolysis by sequentially bringing the flexor digitorum superficialis and flexor digitorum profundus tendons out of the wound gently with a Ragnell retractor. There is currently no study which states whether flexor tendon traction tenolysis should be routinely performed or not. The objective of this study is to compare the outcome in patients who have traction tenolysis performed (A group) versus those who did not have traction tenolysis (B group) performed. It was noted that even though the mean total active motion (TAM) for the B group in our study was lower preoperatively, it was consistently higher than the A group in all the 3 post-operative visits demonstrating a better outcome in the B group. Even though it was not statistically significant, our data also showed that patients with traction tenolysis appeared to have more postoperative pain compared to those without.


HAND ◽  
1983 ◽  
Vol os-15 (2) ◽  
pp. 221-222 ◽  
Author(s):  
J. G. Andersen ◽  
J. W. Brandsma

A patient is presented with bilateral thenar paralysis, due to poliomyelitis. On the right hand a successful abductor digiti minimi transfer was performed. On the left hand weakness of the hypothenar muscles prevented a good result. Subsequently an opponens replacement, using flexor digitorum superficialis from the ring finger, yielded a good result.


2021 ◽  
pp. 175319342110612
Author(s):  
Angelina Garkisch ◽  
Stefanie Schmitt ◽  
Nicole Kim ◽  
Dagmar-C. Fischer ◽  
Karl-Josef Prommersberger ◽  
...  

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.


2019 ◽  
Vol 24 (01) ◽  
pp. 72-75
Author(s):  
Kenji Goto ◽  
Kiyohito Naito ◽  
Yoichi Sugiyama ◽  
Nana Nagura ◽  
Ayaka Kaneko ◽  
...  

Background: The aim of this study was to assess the height of nonunion formation injuring the ulnar-side finger flexor tendon, the positional relationship between the hook of the hamate and little finger flexor tendon was evaluated on CT scans. Methods: The subjects were 20 healthy patients (40 hands) (14 males and 6 females, mean age: 28 years old). Their hands were imaged in extension and flexion of the fingers on CT. The position of the little finger flexor tendon was determined regarding the height of the hook of the hamate as 100%. Results: The heights of the flexor digitorum profundus tendons were 46 ± 6% in extension and 44 ± 9% in flexion, and those of the flexor digitorum superficialis tendons were 87 ± 8% in extension and 91 ± 9% in flexion. Conclusions: Our study suggested that 40% of the base of the hook of the hamate does not contact with the flexor tendon, suggesting that flexor tendon injury is unlikely to occur in that region.


2013 ◽  
Vol 7 (1) ◽  
pp. 282-285 ◽  
Author(s):  
Jun Sasaki ◽  
Toshiro Itsubo ◽  
Koichi Nakamura ◽  
Masanori Hayashi ◽  
Shigeharu Uchiyama ◽  
...  

We present the case of a patient with flexor digitorum profundus tendon laceration at the A2 pulley level caused by an injury to the base of the right ring finger by a knife. The patient was treated by flexor tendon reconstruction from the palm to the fingertip by using the left second toe flexor tendon as a graft, which improved the active range of motion. Further improvement was achieved by subsequent tenolysis, which eventually restored nearly normal function. Our experience with this case indicates that the intrasynovial tendon is a reasonable graft source for the synovial space in fingers and may enable restoration of excellent postoperative function.


2014 ◽  
Vol 40 (3) ◽  
pp. 250-258 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
Y. Maki ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
...  

We evaluated the factors influencing outcomes of flexor tendon repair in 112 fingers using a six-strand suture with the Yoshizu #1 technique and early postoperative active mobilization in 101 consecutive patients. A total of 32 fingers had injuries in Zone I, 78 in Zone II, and two in Zone III. The mean follow-up period was 6 months; 16 patients (19 fingers) participated in long-term follow-up of 2 to 16 years. The total active motion was 230° SD 29°; it correlated negatively with age. The total active motion was 231° SD 28° after repair of the lacerated flexor digitorum superficialis tendon, and was 205° SD 37° after excision of the flexor digitorum superficialis tendon ends ( p = 0.0093). A total of 19 fingers showed no significant increases in total active motion more than 2 years after surgery. The rupture rate was 5.4% in our patients and related to surgeons’ level of expertise. Five out of six ruptured tendons were repaired by inexperienced surgeons. Level of Evidence IV


1989 ◽  
Vol 14 (4) ◽  
pp. 419-421
Author(s):  
P. R. FREWIN ◽  
L. R. SCHEKER

A case is reported where a flap cut of the radial slip of the flexor digitorum superficialis triggered on the proximal border of the A2 pulley within a healed intact tendon sheath. Shaving the flap resolved the problem. This illustrates another post-traumatic mechanical cause of triggering after partial division of flexor tendons.


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