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

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.

2008 ◽  
Vol 33 (5) ◽  
pp. 566-570 ◽  
Author(s):  
N. KANG ◽  
D. MARSH ◽  
D. DEWAR

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.


1991 ◽  
Vol 16 (3) ◽  
pp. 305-310 ◽  
Author(s):  
EMMA FLINDALL ◽  
D. A. McGROUTHER

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.


2003 ◽  
Vol 28 (4) ◽  
pp. 363-368 ◽  
Author(s):  
N. KANG ◽  
A. PRATT ◽  
N. BURR

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.


1988 ◽  
Vol 13 (1) ◽  
pp. 72-74
Author(s):  
A. RICO AGUADO ◽  
V. del PINO PAREDES

The existence of connections, in the form of tendon slips, between the tendons of the flexor pollicis longus and the flexor digitorum profundus indicis has been described by different authors as being a relatively frequent anomaly. Complete fusion between the two muscles, however, must be considered a very rare anomaly. A bilateral case is described, in which the right hand also had post-traumatic adhesions between the two tendons.


1984 ◽  
Vol 9 (2) ◽  
pp. 217-218 ◽  
Author(s):  
P. G. SLATTERY ◽  
D. A. McGROUTHER

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.


Hand Surgery ◽  
2012 ◽  
Vol 17 (02) ◽  
pp. 217-220 ◽  
Author(s):  
Kayoko Furukawa ◽  
Kunitaka Menuki ◽  
Akinori Sakai ◽  
Toshihisa Oshige ◽  
Toshitaka Nakamura

We report a case of Linburg-Comstock syndrome, which is characterized with anomalous tendon slips connecting flexor pollicis longus (FPL) to the flexor digitorum profundus (FDP), usually at the index finger. The present patient started to be a carpenter and was suffering from his disability of flexing the thumb and the index finger independently when he handled the screws in his work. We surgically removed the tendinous connection of the FPL tendon and the index FDP tendon. After surgery, he could work as a carpenter without any difficulty. Surgical disconnection was effective treatment. Dynamic high-resolution ultrasound and three dimensions of computed tomography of the left distal forearm were helpful to confirm the diagnosis.


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