scholarly journals Absence of Flexor Carpi Radialis during an Elective Carpometacarpal Arthroplasty of the Thumb: A Rare Anatomical Variation

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Stratos S. Sofos ◽  
Muhammad Riaz
Keyword(s):  
Tendon Transfer ◽  
Anatomical Variation ◽  
Tendon Graft ◽  
Anatomical Landmark ◽  
Clinical Procedure ◽  
Flexor Carpi Radialis ◽  
Clinical Dilemma ◽  
Operating Surgeon ◽  
Important Structure

Purpose. We present an extremely rare anatomical variation of unilateral flexor carpi radialis (FCR) absence. This rare anatomical variation posed a clinical dilemma to us and we highlight the importance of the surgeon being aware of this anatomical variation of an important structure both as a reconstruction tool and as an anatomical landmark.Methods. This anatomical variation of the unilaterally absent FCR was found upon dissection during a carpometacarpal arthroplasty of the thumb.Results. Upon the discovery of an absent FCR tendon, we proceeded with a simple trapeziectomy.Conclusions. We present an extremely rare anatomical variation of unilateral FCR absence. This rare anatomical variation may pose clinical dilemmas to the operating surgeon who aims to utilise the FCR either for tendon transfer, for tendon graft, or, as seen in our case, in the reconstruction of a carpometacarpal excision at the thumb. We highlight this diagnosis of suspicion, which may influence the clinical procedure.

Anatomical Acromioclavicular Ligament Reconstruction

2005 ◽  
Vol 33 (11) ◽  
pp. 1723-1728 ◽  
Author(s):  
Paul W. Grutter ◽  
Steve A. Petersen
Keyword(s):  
Ligament Reconstruction ◽  
Acromioclavicular Joint ◽  
Tendon Graft ◽  
Longus Tendon ◽  
Flexor Carpi Radialis ◽  
Palmaris Longus ◽  
Fresh Frozen ◽  
Palmaris Longus Tendon ◽  
Mechanism Of Failure ◽  
Surgical Treatments

Background Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. Hypothesis Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. Study Design Controlled laboratory study. Methods The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. Results Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P <. 001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P <. 001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P =. 607). Conclusion The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

scholarly journals Partial flexor carpi radialis tendon transfer technique for midcarpal instability

2019 ◽  
Vol 45 (3) ◽  
pp. 304-306 ◽  
Author(s):  
Hero J. A. Zijlker ◽  
Kennard Harmsen ◽  
Simon D. Strackee
Keyword(s):  
Tendon Transfer ◽  
Flexor Carpi Radialis

Bilateral Extensor Medii Digiti: A Rare Anatomical Variation

1993 ◽  
Vol 18 (5) ◽  
pp. 579-582 ◽  
Author(s):  
M. F. ABU-HIJLEH
Keyword(s):  
Tendon Transfer ◽  
Anatomical Variation ◽  
Morphological Variability ◽  
Proximal Phalanx ◽  
Hand Surgery ◽  
Middle Finger ◽  
Review Of The Literature ◽  
Male Cadaver ◽  
Clinically Significant ◽  
Transfer Procedures

A supernumerary extensor muscle to the middle finger was found to be present bilaterally in a male cadaver. It originated from the distal end of the ulna and its tendon inserted into the proximal phalanx of the middle finger. The bilateral presence and manner of insertion appear to be unique from a review of the literature. Morphological variability and clinical significance are reviewed. Such variations may be clinically significant during hand surgery, especially tendon transfer procedures.

scholarly journals Evaluation of Extensor Pollicis Brevis as a Recipient of Tendon Transfer for Thumb Extension

2019 ◽  
Vol 52 (02) ◽  
pp. 171-177 ◽  
Author(s):  
Praveen Bhardwaj ◽  
Poonacha Puchimada Muddappa ◽  
Dadi Bindesh ◽  
Shanmuganathan Raja Sabapathy
Keyword(s):  
Tendon Transfer ◽  
Anatomical Variation ◽  
Excellent Result ◽  
Extensor Tendon ◽  
Interphalangeal Joint ◽  
Radial Nerve Palsy ◽  
Brachial Plexus Palsy ◽  
Extensor Pollicis Longus ◽  
Extensor Pollicis Brevis ◽  
Flexor Carpi Ulnaris

Abstract Introduction Rerouting of the extensor pollicis longus (EPL) is the standard part of tendon transfer surgery for thumb extension. It is done to overcome the ulnar vector of the EPL action. Extensor pollicis brevis (EPB), however, produces better thumb abduction and extension by virtue of its radial vector. The described anatomical variation of EPB extending the thumb interphalangeal joint (IPJ), therefore, gives the “best combination” of movements by a single-thumb extensor tendon. Materials and Methods We performed this transfer in six patients in whom the EPB was found to be extending the IPJ while checked intraoperatively. Three of these six patients were cases of radial nerve palsy and the other three presented with brachial plexus palsy. The outcome was assessed by measuring palmar and radial abduction of the thumb, Kapandji’s score, and Bincaz’s scale. Results We found satisfactory results in all the six patients. In our series, patients had an average radial extension of the thumb of 29.2 degrees and an average palmar abduction of the thumb of 65.7 degrees. On evaluation with the Bincaz score; one patient had excellent result, three patients had good results, and two patients had fair results. Conclusion In situations where EPL rerouting is not possible (as in cases where the donor tendon needs to reach the thumb from the ulnar side, for example, flexor carpi ulnaris), transfer to the EPB, provided it is extending the thumb IPJ, would produce better extension and abduction of the thumb than the transfer to the EPL.

scholarly journals Bilateral FCR Tendon Injury Associated with Osteoarthritis of the STT Joint

2020 ◽  
Vol 09 (04) ◽  
pp. 362-364
Author(s):  
Hiroaki Takami ◽  
Kuniichi Aso
Keyword(s):  
Grip Strength ◽  
Tendon Rupture ◽  
Hand Surgery ◽  
Tendon Graft ◽  
Tendon Injury ◽  
Left Wrist ◽  
Tendon Reconstruction ◽  
Flexor Carpi Radialis ◽  
Right Hand ◽  
Tendon Ruptures

AbstractSubcutaneous flexor carpi radialis (FCR) tendon ruptures secondary to osteoarthritis of the scapho-trapezio-trapezoidal (STT) joint are very rare. A 53-year-old female suffered a subcutaneous FCR tendon rupture after noticing pain in her right wrist. Because of continuing pain and decreasing strength in her right hand, surgery of the STT joint arthrodesis and an FCR tendon reconstruction with free tendon graft was performed. Her left wrist gradually showed the same symptoms 9 years later. The STT fusion for her left wrist was then performed. The FCR tendon was partially worn out on the spur of the trapezial ridge as well. Only 10 cases of FCR tendon ruptures have been reported due to definite STT osteoarthritis in six English papers. We believe STT fusion should be done without hesitation before tendon rupture occurs, and when motion pain around the STT joint and decreasing grip strength exists. However, it is controversial whether the FCR tendon reconstruction should be done in addition to STT fusion.

Thyroid tubercle of Zuckerkandl: anatomical and surgical experience from 79 thyroidectomies

2008 ◽  
Vol 123 (7) ◽  
pp. 768-771 ◽  
Author(s):  
C Page ◽  
P Cuvelier ◽  
A Biet ◽  
P Boute ◽  
M Laude ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Recurrent Laryngeal Nerve ◽  
Thyroid Surgery ◽  
Anatomical Variation ◽  
Lateral Lobe ◽  
Anatomical Variations ◽  
Anatomical Landmark ◽  
Laryngeal Nerve ◽  
Surgical Experience ◽  
The Right

AbstractObjective:To highlight a poorly known anatomical variation of the lateral lobe of the thyroid gland, which can be useful in identifying the recurrent laryngeal nerve during thyroid surgery.Materials and methods:We performed a three-year prospective study of 79 thyroid surgery patients. Great attention was paid to anatomical variations of the thyroid gland (i.e. the presence or absence of a distinct tubercle of Zuckerkandl), the recurrent laryngeal nerve and the location of the parathyroid glands.Results:A total of 71 right lobectomies and 74 left lobectomies were performed. Five tubercles of Zuckerkandl were identified (7.04 per cent of cases) and were useful in detecting the recurrent laryngeal nerve (but only on the right side).Conclusion:The tubercle of Zuckerkandl is a poorly known and variable anatomical feature of the thyroid gland which may not, in fact, be so rare. It arises for embryological reasons, and it can be a reliable anatomical landmark for identifying the recurrent laryngeal nerve during thyroid surgery. It should be included in the Nomina Anatomica as the ‘processus posterior glandulae thyroideae’ described by Zuckerkandl.

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