Resistive testing in a patient with suspected zone I flexor tendon injury

Hand Therapy ◽  
2009 ◽  
Vol 14 (3) ◽  
pp. 83-85
Author(s):  
Gangatharam Sudhagar ◽  
Monique Leblanc
Keyword(s):  
Occupational Therapy ◽  
Flexor Tendon ◽  
Tendon Injury ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Hand Surgeon ◽  
Flexor Tendon Injury ◽  
Distal Interphalangeal

Lacerations are the major cause of flexor tendon injury in zone I and they are most commonly missed due to incomplete examinations. We report a case of lacerated flexor tendon injury in Zone I closed without explorations and which was referred to occupational therapy with the diagnosis of stiff hand. The patient received therapy for his stiff hand following which he could flex the distal interphalangeal joint (DIP) on blocking the proximal interphalangeal joint but failed to flex his DIP joint on making a composite fist. With resistive testing the patient failed to initiate resistance on flexion. The patient was referred back to the hand surgeon and subsquently diagnosed with a flexor tendon injury.

The outcomes of zone 1 flexor tendon injuries treated using micro bone suture anchors

2013 ◽  
Vol 38 (9) ◽  
pp. 973-978 ◽  
Author(s):  
S. Huq ◽  
S. George ◽  
D. E. Boyce
Keyword(s):  
Range Of Motion ◽  
Flexor Tendon ◽  
Proximal Interphalangeal Joint ◽  
Tendon Injuries ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Flexor Tendon Injuries ◽  
Distal Interphalangeal ◽  
Bone Anchors ◽  
The Mean

This article evaluates the outcome of 42 consecutive zone 1 flexor tendon injuries treated by using micro bone anchors during the period 2003–2008. Patients were rehabilitated using the modified Belfast Regime. The range of motion at the distal interphalangeal joint was assessed using Moiemen’s classification. A total of 56% of patients achieved excellent or good results for range of motion at the distal interphalangeal joint and 23% had a poor outcome. The mean distal interphalangeal joint and proximal interphalangeal joint range of motion were 48° and 96°, respectively. A total of 94% of patients returned back to work by 12 weeks. One patient sustained a tendon rupture and one developed osteomyelitis. The mean QuickDASH score was 13.5 and 81% of patients were satisfied with their outcomes. This is the largest clinical study on the use of bone anchors for zone 1 tendon injuries. Our study demonstrated a low rate of complications and outcomes that compare favourably with other published techniques.

Volar plating versus external fixation for unstable dorsal fracture-dislocations of the proximal interphalangeal joint

2021 ◽  
pp. 175319342110593
Author(s):  
Atsuhiko Murayama ◽  
Kentaro Watanabe ◽  
Hideyuki Ota ◽  
Shigeru Kurimoto ◽  
Hitoshi Hirata
Keyword(s):  
External Fixation ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Volar Plating ◽  
Distal Interphalangeal Joint ◽  
Active Flexion ◽  
Plate Group ◽  
Fracture Dislocations ◽  
Distal Interphalangeal

We retrospectively compared the results of volar plating and dynamic external fixation for acute unstable dorsal fracture-dislocations of the proximal interphalangeal joint with a depressed fragment. We treated 31 patients (31 fingers), 12 with volar buttress plating and 19 with dynamic external fixation. Follow-up averaged 35 and 40 months in the two groups, with a minimal 6-month follow-up. Average active flexion of the proximal interphalangeal joint was 95° after plate fixation and 87° after external fixation, with an active extension lag of –6° and –9°, respectively. Active flexion at the distal interphalangeal joint averaged 67° in the plate group and 58° in the external fixation group, with active extension lags of 0° and –5°, respectively. We conclude that both methods can obtain a good range of motion at the proximal interphalangeal joint. A limitation of the extension of the distal interphalangeal joint occurred with dynamic external fixation but not with volar buttress plating. Level of evidence: IV

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.

Irreducible Dislocation of the Distal Interphalangeal Joint

1985 ◽  
Vol 10 (2) ◽  
pp. 231-232
Author(s):  
Y. MURAKAMI
Keyword(s):  
Flexor Tendon ◽  
Interphalangeal Joint ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal

A case of irreducible dislocation of the distal interphalangeal joint of the finger caused by entrapment of the deep flexor tendon is reported.

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