Adhesions as a component of the trigger finger: a dynamic sonographic study

2020 ◽  
pp. 175319342096929
Author(s):  
Xue Ling Chuang ◽  
Duncan A. McGrouther
Keyword(s):  
Flexor Digitorum Profundus ◽  
Level Of Evidence ◽  
Surrounding Soft Tissue ◽  
Flexor Tendons ◽  
Differential Motion ◽  
Healthy Control ◽  
Distal Interphalangeal ◽  
Passive Flexion ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

We performed a detailed dynamic high-resolution ultrasound examination of the flexor tendons in trigger fingers and compared this with normal contralateral digits. There was a loss of defined linear tendon margins and/or traction of the flexor tendons on the surrounding soft tissue during passive flexion of the distal interphalangeal joint in 17 out of 20 trigger fingers, which indicated adherence to the surrounding tissues. The differential motion between the flexor digitorum profundus tendon and the flexor digitorum superficialis tendons was also lost in ten trigger fingers, which suggested adherence between the tendons. No signs of peritendinous or intertendinous adhesions were found in the healthy control fingers. We conclude that tendon adhesions are present in the majority of trigger fingers. We could not determine a relationship between the severity of triggering and the presence of adherence due to limited sample size. Level of evidence: II

Rupture of Flexor Digitorum Profundus to the Index Finger after a Distal Radial Fracture

1987 ◽  
Vol 12 (1) ◽  
pp. 115-116
Author(s):  
L. A. RYMASZEWSKI ◽  
A. P. WALKER
Keyword(s):  
Index Finger ◽  
Flexor Digitorum Profundus ◽  
Distal Radial Fracture ◽  
Radial Fracture ◽  
Successful Result ◽  
Flexor Tendons ◽  
Bony Fragment ◽  
One Year ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

Attrition ruptures of flexor tendons to the fingers following Colles’ fractures are very rare. In the case reported here, a protruding bony fragment caused a delayed rupture of the flexor digitorum profundus tendon to the index finger one year after a fracture of the distal end of the radius. Suture of the distal end of the tendon to the adjacent profundus tendon two years after the fracture produced a successful result.

Sonographic study of repair, gapping and tendon bowstringing after primary flexor digitorum profundus repair in zone 2

2018 ◽  
Vol 43 (5) ◽  
pp. 480-486 ◽  
Author(s):  
Lisa Reissner ◽  
Nadja Zechmann-Mueller ◽  
Holger Jan Klein ◽  
Maurizio Calcagni ◽  
Thomas Giesen
Keyword(s):  
Clinical Outcomes ◽  
Ultrasound Examination ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Level Of Evidence ◽  
Repair Site ◽  
Heterotopic Ossifications ◽  
Finger Motion ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

We report sonographic findings with clinical outcomes after zone 2 flexor digitorum profundus tendon repairs in ten fingers. The tendons underwent a six-strand M-Tang core repair, no circumferential suture, and partial or complete division of the pulleys. Over 12 months after surgery and using ultrasound, we found no gapping at the repair site during finger motion. When the pulleys were divided, there was sonographic evidence of tendon bowstringing, but the bowstringing was minimal. Clinically, we did not find any fingers that displayed tendon bowstringing or had functional loss. With ultrasound examination, the repaired tendons remained enlarged over 12 months. Two patients developed heterotopic ossifications at the repair site without tendon gliding, and these required tenolysis. We conclude that the tendon repair site does not gap when a strong core suture is used in the repair without adding peripheral sutures. There is no notable tendon bowstringing clinically, though the repaired tendons have sonographic evidence of minor bowstringing. Level of evidence: III

Flexor digitorum profundus with or without flexor digitorum superficialis tendon repair in acute Zone 2B injuries

2020 ◽  
Vol 45 (10) ◽  
pp. 1034-1044
Author(s):  
Ahmed F. Sadek
Keyword(s):  
Tendon Repair ◽  
Flexion Contracture ◽  
Flexor Digitorum Profundus ◽  
Flexor Digitorum Superficialis ◽  
Level Of Evidence ◽  
Power Grip ◽  
Contralateral Hand ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A total of 53 patients with complete cuts of two flexor tendons in Zone 2B treated over a 9-year period was reviewed. Twenty-three patients (28 fingers) had only flexor digitorum profundus repair, while 30 patients (36 fingers) had both flexor digitorum profundus and flexor digitorum superficialis repairs, with a mean follow-up of 21 months (range 12–84). The decision to repair the flexor digitorum superficialis was made according to intraoperative judgement of ease of repair and gliding of the flexor digitorum profundus tendon. Two groups of patients showed no significant differences in total range of active or passive digital motion and power grip percentage to the contralateral hand. However, the values of power grip were statistically superior in the patients with both tendons repaired. The patients after flexor digitorum profundus-only repairs showed significantly greater but still mild flexion contracture (mean 20 °) of the operated digits. The Tang gradings were the same with 89% good and excellent rates in both groups. The conclusion is that although repair of both flexor digitorum profundus and flexor digitorum superficialis tendons is slightly more preferable based on increased grip strength, the repair of the flexor digitorum superficialis together with flexor digitorum profundus is not mandatory. Whether or not to repair flexor digitorum superficialis is an intraoperative decision based on the ease of gliding of the repaired tendon(s). Level of evidence: III

The Morbidity of the Button-over-Nail Technique for Zone 1 Flexor Tendon Repairs. Should we still be using this Technique?

2008 ◽  
Vol 33 (5) ◽  
pp. 566-570 ◽  
Author(s):  
N. KANG ◽  
D. MARSH ◽  
D. DEWAR
Keyword(s):  
Flexor Tendon ◽  
Interphalangeal Joint ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Close Attention ◽  
The Core ◽  
Joint Infections ◽  
Distal Interphalangeal ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

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.

Accessory Roles of the Vinculum Breve of the Flexor Digitorum Profundus and Check-Rein Ligaments at the Distal Interphalangeal Joint

1991 ◽  
Vol 16 (3) ◽  
pp. 305-310 ◽  
Author(s):  
EMMA FLINDALL ◽  
D. A. McGROUTHER
Keyword(s):  
Interphalangeal Joint ◽  
Volar Plate ◽  
Flexor Digitorum Profundus ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

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.

A New Technique of Attachment of Flexor Tendons to The Distal Phalanx without A Button Tie-Over

1996 ◽  
Vol 21 (5) ◽  
pp. 629-632 ◽  
Author(s):  
M. K. SOOD ◽  
D. ELLIOT
Keyword(s):  
Flexor Tendon ◽  
Distal Phalanx ◽  
New Technique ◽  
Flexor Digitorum Profundus ◽  
Flexor Tendons ◽  
Tendon Grafts ◽  
A New Technique ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

A new technique of attachment of the flexor digitorum profundus tendon and flexor tendon grafts to the distal phalanx, without using a button on the nail, is described and its use reported in 14 cases.

Primary Flexor Tendon Repair in Zone 1

2000 ◽  
Vol 25 (1) ◽  
pp. 78-84 ◽  
Author(s):  
N. S. MOIEMEN ◽  
D. ELLIOT
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Range Of Movement ◽  
Realistic Assessment ◽  
Distal Interphalangeal ◽  
Active Mobilization ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon ◽  
Distal Tendon

This paper presents an analysis of the results of repair of 102 complete flexor tendon disruptions in zone 1 which were rehabilitated by an early active mobilization technique during a 7 year period from 1992 to 1998. These injuries were subdivided into: distal tendon divisions requiring reinsertion; more proximal tendon divisions but still distal to the A4 pulley; tendon divisions under or just proximal to the A4 pulley; and closed avulsions of the flexor digitorum profundus tendon from the distal phalanx. Assessment by Strickland’s original criteria showed good and excellent results of 64%, 60%, 55% and 67% respectively in the four groups. However, examination of the results measuring the range of movement of the distal interphalangeal (DIP) joint alone provided a more realistic assessment of the affect of this injury on DIP joint function, with good and excellent results of only 50%, 46%, 50% and 22% respectively in the four groups.

CONGENITAL DEFECTS OF THE FLEXOR DIGITORUM PROFUNDUS TENDON OF THE LITTLE FINGER

Hand Surgery ◽  
2014 ◽  
Vol 19 (02) ◽  
pp. 253-256 ◽  
Author(s):  
Masatoshi Fukuoka ◽  
Shinichiro Takayama ◽  
Atuhito Seki
Keyword(s):  
Fibrous Tissue ◽  
Ring Finger ◽  
Flexor Digitorum Profundus ◽  
Congenital Defects ◽  
Active Flexion ◽  
Repeated Surgery ◽  
Distal Interphalangeal ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon ◽  
Little Finger

The cases of two patients, a four-year-old boy and an eight-year-old boy, who had been incapable of active flexion of the little finger since birth, are presented. They were capable of active flexion of the metacarpophalangeal (MP) joint, but not of the proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints. They were diagnosed with a defect of the flexor digitorum profundus (FDP) tendon of the little finger and underwent surgery. In both cases, the FDP tendon turned into fibrous tissue proximal to the palm and lost continuity on this side. Reconstruction was performed by making an end-to-side anastomosis of the residual proximal end of the FDP tendon to the FDP tendon of the ring finger in the palmar region. Although one patient required repeated surgery due to post-operative tendon adhesion, good outcomes were achieved, with both patients becoming capable of active flexion.

FLEXOR DIGITORUM PROFUNDUS TENDON AVULSION THROUGH A RECURRENT ENCHONDROMA — A CASE REPORT

Hand Surgery ◽  
2001 ◽  
Vol 06 (01) ◽  
pp. 125-126 ◽  
Author(s):  
Darren B. Chen ◽  
David C. Yee
Keyword(s):  
Case Report ◽  
Ring Finger ◽  
Distal Phalanx ◽  
Flexor Digitorum Profundus ◽  
Contact Sport ◽  
Distal Interphalangeal ◽  
Flexor Digitorum ◽  
Tendon Avulsion ◽  
Flexor Digitorum Profundus Tendon

Flexor digitorum profundus (FDP) tendon avulsion from the distal phalanx is a well recognised injury, which usually follows a hyperextension force to a flexed distal interphalangeal (DIP) joint. It is commonly seen in contact sport athletes, with a predilection for the ring finger.2,4 Avulsion of the FDP tendon from pathological bone is an infrequent occurrence. It has, however, been reported to occur in association with an enchondroma of the distal phalanx.2,3 To our knowledge, an FDP tendon avulsion through a recurrent enchondroma has not been reported. We present the case findings of such an event.

Sign in / Sign up

Export Citation Format

Share Document