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.

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.

Non—Traumatic Flexion Deformity of the Proximal Interphalangeal Joint—Its Pathogenesis and Treatment

HAND ◽  
1983 ◽  
Vol os-15 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Takayuki Miura
Keyword(s):  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Middle Phalanx ◽  
Flexion Deformity ◽  
Splint Therapy ◽  
Extensor Apparatus ◽  
Long Time ◽  
Dynamic Splint ◽  
Flexor Digitorum ◽  
Flexion And Extension

The pathogenesis of camptodactyly may be the lack of equilibrium between the flexion and extension forces. The imbalance must be a result of palmar translocation of lateral slips of the extensor apparatus due to anchoring of the middle phalanx in the flexed position by fibrous substrata, abnormal shortening of the flexor digitorum superficialis or abnormal insertion of the lumbricals. It is reasonable therefore to start dynamic splint therapy as early as possible and carry on for a long time. Long-standing malposition of the extensor lateral slips possibly introduced contracture of periarticular tissues and the transverse retinacular ligament, making treatment more difficult. For those patients resistant to dynamic splint therapy, a surgical procedure is necessary. Surgical procedures are discussed.

Advantages and Drawbacks of Proximal Interphalangeal Joint Fusion Versus Flexor Tendon Transfer in the Correction of Hammer and Claw Toe Deformity. A Finite-Element Study

2010 ◽  
Vol 132 (5) ◽  
Author(s):  
Javier Bayod ◽  
Marta Losa-Iglesias ◽  
Ricardo Becerro de Bengoa-Vallejo ◽  
Juan Carlos Prados-Frutos ◽  
Kevin T. Jules ◽  
...  
Keyword(s):  
Finite Element ◽  
Tendon Transfer ◽  
Proximal Phalanx ◽  
Delayed Union ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
The Finite Element Method ◽  
Flexor Digitorum Brevis ◽  
Flexor Digitorum ◽  
Toe Deformity

Correction of claw or hammer toe deformity can be achieved using various techniques, including proximal interphalangeal joint arthrodesis (PIPJA), flexor digitorum longus tendon transfer (FDLT), and flexor digitorum brevis transfer. PIPJA is the oldest technique, but is associated with significant complications (infection, fracture, delayed union, and nonunion). FDLT eliminates the deformity, but leads to loss of stability during gait. Flexor digitorum brevis tendon transfer (FDBT) seems to be the best surgical alternative, but it is a recent technique with still limited results. In this work, these three techniques have been analyzed by means of the finite-element method and a comparative analysis was done with the aim of extracting advantages and drawbacks. The results show that the best technique for reducing dorsal displacement of the proximal phalanx is PIPJA (2.28 mm versus 2.73 mm for FDLT, and 3.31 mm for FDBT). However, the best technique for reducing stresses on phalanges is FDLT or FDBT (a reduction of approximately 35% regarding the pathologic case versus the increase of 7% for the PIPJA in tensile stresses, and a reduction of approximately 40% versus 25% for the PIPJA in compression stresses). Moreover, the distribution of stresses in the entire phalanx is different for the PIPJA case. These facts could cause problems for patients, in particular, those with pain in the surgical toe.

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.

An Unusual Role of the Vinculum after Complete Laceration of the Flexor Tendons

1987 ◽  
Vol 12 (1) ◽  
pp. 105-108
Author(s):  
Y. SASAKI ◽  
S. NOMURA
Keyword(s):  
Clinical Diagnosis ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Superficialis ◽  
Flexor Tendons ◽  
Full Flexion ◽  
Flexor Digitorum ◽  
Flexion Strength

Two cases are described with full flexion of the proximal interphalangeal joint produced by an intact short vinculum after complete laceration of both superficialis and profundus tendons. To establish the clinical diagnosis of complete flexor digitorum superficialis division, the necessity of examining the flexion strength of an injured finger is emphasized.

SUBCUTANEOUS RUPTURE OF THE FLEXOR TENDON OF THE LITTLE FINGER ASSOCIATED WITH ANOMALOUS FLEXOR DIGITORUM SUPERFICIALIS

Hand Surgery ◽  
2007 ◽  
Vol 12 (02) ◽  
pp. 87-90
Author(s):  
Hiroya Senda ◽  
Hidenori Muro
Keyword(s):  
Flexor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Superficialis ◽  
Anomalous Muscle ◽  
Distal Interphalangeal ◽  
Hook Of Hamate ◽  
Flexor Digitorum ◽  
A1 Pulley ◽  
Little Finger

A 59-year-old man suffered from subcutaneous rupture of the flexor tendon of the little finger associated with fracture of the hook of hamate. He could not flex his little finger completely at the distal interphalangeal joint, but incomplete flexion of the proximal interphalangeal joint was possible. Surgical exploration revealed anomaly of the flexor digitorum superficialis of the little finger, as it originated from the palmar aspect of the carpal ligament, and a small portion of the muscle belly was traversed toward the A1 pulley over the profundus tendon and then it ran into the A1 pulley as a normal superficialis tendon. The flexor digitorum superficialis of the little finger is well known to show variations, but our case is extremely rare, and furthermore there are no reports in the available literatures about the function of this anomalous muscle.

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