Absence of Flexor Digitorum Superficialis Tendon in the Little Finger                     is not Associated with Decreased Grip Strength

Puhaindran, Mark E.; Sebastin, Sandeep J.; Lim, Aymeric; Xu, Wenxian; Chen, Y. M.

doi:10.1177/1753193408087229

Cited by 19 publications

(24 citation statements)

References 14 publications

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“…Bowman et al [8] reported that those male and female subjects had similar frequencies of FDSabsent tendons. Similarly, Puhaindran et al [3] found similar frequencies in both sexes. Conversely, Wilcox et al [12] found that female subjects had more common absent function than male subjects.…”

Section: Discussionmentioning

confidence: 66%

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The prevalence of functional absence of flexor digitorum superficialis to the little finger: A study in a Turkish population

Güler

Köse

Turan

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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This prospective study was conducted to determine the prevalence of absence of flexor digitorum superficialis (FDS)-V tendon and to investigate the clinical usefulness of symmetry patterns, differences between sex, laterality, and dexterity in a Turkish population. Four hundred randomly-selected adult patients were examined for the absence of FDS-V function. The absence of FDS-V on both sides, results of the examination tests, age, sex, and dexterity were recorded and analysed statistically. The overall prevalence of absence of FDS-V was 18.5% in the Turkish population. The prevalence of functional absence of FDS-V was statistically similar between the body sides and sex (p = 0.258 and p = 0.333). The prevalence of symmetric occurrence of the variations in both hands was 87.2%. If a functional FDS is demonstrated in one hand, the probability of having a functional FDS-V in the contralateral hand is 91.8%. However, when the FDS-V is absent in one hand, the probability of having an absent FDS-V in the contralateral hand is 51.1%. The symmetric occurrence of variations was equally distributed in both sex and dexterity (p = 0.223 and p = 0.201). Prediction of FDS-V function in one hand through examining the opposite hand may cause false negative or false positive results. However, if the uninjured hand has independent FDS-V function, the inability to flex the PIP joint in the injured hand can be accepted as an injury to the FDS and surgical exploration should be performed. However, if the uninjured hand has an absent function, assumption of symmetric distribution should not be used.

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Section: Discussionmentioning

confidence: 66%

“…Because these variants do not affect the functions of the hand regarding grip strength and activities in daily life, they usually do not attract clinical attention [3]. However, these anatomic variants may cause misinterpretation during the evaluation of a patient with flexor tendon injuries [4].…”

Section: Introductionmentioning

confidence: 99%

The prevalence of functional absence of flexor digitorum superficialis to the little finger: A study in a Turkish population

Güler

Köse

Turan

et al. 2013

Journal of Plastic Surgery and Hand Surgery

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“…Out of 171 subjects, it was found that the FDS-V was absent in 18.6% of females and 15.3% of males and in those subjects, grip strength was significantly lower than in subject groups with independent or common (attached to FDS of fourth finger) function of FDS-V(10). Another study, in contrast, found that there was no significant difference seen in grip strength between subjects who had an FDS-V and those who did not(11). Despite the wide variability of the presence of and the conflicting information as to the functional impact of the FDS-V, current clinical examination techniques are inadequate to discriminate among the possible variations or absence of FDS(12).…”

Section: Discussionmentioning

confidence: 96%

Hypotheses for ongoing evolution of muscles of the upper extremity

2014

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“…10,11 Therefore the presence or absence of FDS to the little finger on the other side adds little to the assessment. Each tendon has a long vinculum proximally, where they need to accommodate more excursion, and a short vinculum more distally.…”

Section: History and Examinationmentioning

confidence: 99%

Flexor tendon injuries

Tucker

Williams

2015

Plastic and Reconstructive Surgery

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An in-depth knowledge of the anatomy and biomechanics of the flexor tendon system is essential to every stage of the management of flexor tendon injuries from diagnosis, surgery, correct assessment of complications through to secondary surgery. It must be remembered that this is a carefully balanced system with the function of any particular muscle not depend ing only on its origin and insertion, but the complex interplay between the system of pulleys in the hand and the balancing forces of all the muscles acting across the intervening joints. For example the effect of flexor digitorum profundus (FDP) acting alone would be to act purely at the distal interphalangeal (DIP) joint until this was fully flexed before acting at the proximal interphalangeal (PIP) joint in a similar manner, followed by the metacarpophalangeal (MCP) joint and lastly the wrist. However in normal function, such as grasping an object, the action of FDP will always be accompanied by balancing tensions in other muscles, and moderated by the pulley system to produce the desired functional outcome. For example, in grasping an object the wrist is stabilized and the joints of the finger are simulta neously flexed around the object. Figure 51.1 shows the structure of flexor digitorum superfi cialis (FDS) as it divides and rejoins to become deep to FDP just before its insertion. This illustrates the complexity of just one element of the interplay between anatomy and function.The wrist flexors and FDS are part of the superficial flexor muscle mass in the forearm arising from the common flexor origin. Both of the wrist flexors have pulley systems close to their insertions that redirect the vector of force and thereby increase the efficiency of their action. The flexor carpi radialis (FCR) is redirected by the scaphoid before being inserted into the bases of the second and third metacarpals and the flexor carpi ulnaris (FCU) is redirected by the pisiform before its insertion into the base of the fifth metacarpal. The FDS muscle also has an origin from the radius, and provides independent control of pull for the FDS tendon to each digit, with the exception that the action on the little and ring is sometimes conjoined (see under Clinical examination below). The function of FDS is partly to assist with power grip, but more importantly provides individual finger flexion as required in manipulation of objects in the hand and in fine motor skills. As the FDS is inserted into the base of the middle phalanx, it acts mainly at the PIP joint, but also crosses the wrist and MCP joint, where the magnitude of its effect is determined by the balance of tension in the other muscles act ing at these sites, such as the wrist flexors and extensors, the long finger extensors, and, importantly, the interossei and lumbricals.The deep flexor muscle mass consists of flexor pollicis longus (FPL) arising from the palmar surface of the body of the radius, and the FDP arising from the ulna. FPL is the only flexor of the thumb and provides the strongest pull of all the flexors to...

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Absence of Flexor Digitorum Superficialis Tendon in the Little Finger is not Associated with Decreased Grip Strength

Cited by 19 publications

References 14 publications

The prevalence of functional absence of flexor digitorum superficialis to the little finger: A study in a Turkish population

The prevalence of functional absence of flexor digitorum superficialis to the little finger: A study in a Turkish population

Hypotheses for ongoing evolution of muscles of the upper extremity

Flexor tendon injuries

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