Independent index extension after indicis proprius transfer: Excision of juncturae tendinum

Kitano, Keiji; Tada, Koichi; Shibata, Toru; Yoshida, Takeshi

doi:10.1016/s0363-5023(96)80306-6

Cited by 20 publications

(14 citation statements)

References 6 publications

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“…6,16,[32][33][34] For example, although quantitative data are lacking, excision of the juncturae tendinum has been reported to increase the independence of finger movements in human patients undergoing surgery to restore impaired hand function due to trauma, arthritis, nerve damage, or spinal cord injury. 16 Also, removal of the juncturae tendinum and webbing between the fingers in cadaver hands was shown to result in more fractionated finger extension movements when tension was applied to individual tendons. 32 Modeling work also suggests that surgical resection of the junturae tendinum should result in a greater independence of finger movements.…”

Section: Discussionmentioning

confidence: 99%

Role of intertendinous connections in distribution of force in the human extensor digitorum muscle

Keen

Fuglevand

2003

Muscle and Nerve

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The human extensor digitorum (ED) muscle gives rise distally to multiple tendons that insert onto and extend digits 2-5. It has been shown previously that the spike-triggered average forces of motor units in ED are broadly distributed across many tendons. Such force dispersion may result from linkages between the distal tendons of ED and may limit the ability to move the fingers independently. The purpose of this study, therefore, was to determine the extent to which the connections between tendons of ED distribute force across the fingers. Stimulation of ED muscle fibers was performed at 107 different sites in four subjects. The isometric force exerted on digits 2-5 resulting from the stimulation was measured separately. Stimulus-triggered averaging of each of the four force channels yielded the force contribution to each of the digits due to the stimulation at each site. A selectivity index from 0 (a site that distributes force equally across the fingers) to 1.0 (a site that produces force on a single finger) was computed to describe the distribution of force across the four fingers. The selectivity index resulting from electrical stimulation of ED averaged 0.70 +/- 0.21. These selectivity index values were significantly greater (P < 0.001) than those obtained for single motor units using spike-triggered averaging. These findings suggest that linkages between the distal tendons of ED probably play only a minor role in distributing force across the fingers and, therefore, other factors must be primarily responsible for the inability to move the fingers independently.

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Section: Discussionmentioning

confidence: 99%

Role of intertendinous connections in distribution of force in the human extensor digitorum muscle

Keen

Fuglevand

2003

Muscle and Nerve

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“…The overall prevalence of EIP Twenty-one studies reported the prevalence of EIP [1,2,4,6,7,10,12,15,16,18,19,21,24,26,29,32,42,47,48,50] with a total of 3858 hands and a PPE of 96.5 % (95 % CI 0.928-0.989, I 2 = 96.2 %). The prevalence of the EIP in the included studies is shown in Table 2.…”

Section: The Prevalence Of Eipmentioning

confidence: 99%

The prevalence of the extensor indicis tendon and its variants: a systematic review and meta-analysis

Yammine

2014

Surg Radiol Anat

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The tendon of the extensor indicis (EI) is frequently used to restore the loss of function in other digits. However, it shows many variations which include splitting of the extensor indicis proprius (EIP) into two or three distal slips, attachment to fingers other than the index such as the extensor medii proprius (EMP), attachment onto the index and the third finger such as the extensor indicis et medii communis, or attachment to both the index and the thumb such as the extensor pollicis et indicis (EPI). This systematic review gathers the available data on the prevalence of EI tendon and its variation in the hand. Twentynine cadaveric studies met the inclusion criteria with a total of 3858 hands. Meta-analysis results yielded an overall pooled prevalence estimate (PPE) of EI of 96.5 % and PPEs of 92.6, 7.2 and 0.3 % for the single-, double-and triple-slip EIP, respectively. The single-slip EIP is frequently inserted on the ulnar side of the extensor digitorum communis of the index (EDC-index) in 98.3 %. The double-slip EIP is located on the ulnar side of the EDC-index in 53.5 %, on its radial side in 17 % and on both sides in 28.7 %. Indian populations showed the highest rate of single-slip EIP and the lowest rate of double-slip EIP when compared to Japanese, Europeans and North Americans. The pooled prevalence of EMP, EMIC and EPI were 3.7, 1.6 and 0.75 %, respectively. Knowledge of the variants of the EI tendon and their prevalence should help surgeons in correctly choosing the tendon to transfer in hand surgery.Keywords Extensor indicis proprius Á Extensor medii proprius Á Extensor indicis et medii Á Communis Á Extensor pollicis et indicis Á Anatomy Á Meta-analysis

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“…The extensor tendons are distally together by oblique interconnections, juncturae tendinum (JT). The most important functional roles reported to the JT are more useful for repairing the dorsal aponeurosis and identifying of the ED tendons of the hand (von Botte, 1993, 1995;Kitano et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

“…The anatomic variations of the extensor muscle tendons and prevalence have been documented in clinical and anatomic studies (von Botte, 1993, 1995;Gonzalez et al, 1995;Kitano et al, 1996;Tan and Smith, 1999). Even though the studies of the importance of anatomical features of tendons in hand dynamics serve as milestones, there is still a great need for more detailed studies.…”

Section: Introductionmentioning

confidence: 99%

The anatomical variations of the extensor tendons to the dorsum of the hand

et al. 2008

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To lead a quality life, tendon repair must be performed in a trauma causing damage to the extensor tendon of the hand. The aim of this study is to study the structures that can be used as donor tendons. Fifty-four dissected adult hands were examined to study the pattern of the extensor tendons on the dorsum of the hand. The most common distribution patterns of the extensor tendons of the fingers were as follows: a single extensor indicis proprius (EIP) tendon which inserted ulnar to the extensor digitorum (ED)-index; a single ED-index; a single ED-middle; a single ED-ring; an absent ED-little; a double extensor digiti minimi (EDM), and a single ED-ring to the little finger. The frequency of the number of tendons is as follows: a single (87.03%) EIP, a single ED-index (100%), a single (92.6%) ED-middle, a single (75.9%) ED-ring, and an absent (68.5%) or a single (24.1%) ED-little. A double (88.9%) EDM tendons were seen. The thickest type of juncturae tendinum (JT) is found primarily between the ring and little fingers (90%). Suitable excessive tendon and the thickest JT as donor tendon were found in the fourth intermetacarpal space. The present findings, especially the fourth intermetacarpal space, may explain why incisions on the dorsum of the hand should be large and performed with particular care. It is necessary to have a thorough understanding of the arrangements of the multiple extensor muscles and their junctural connections of the hand when tenoplasty or tendon transfer is required.

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Independent index extension after indicis proprius transfer: Excision of juncturae tendinum

Cited by 20 publications

References 6 publications

Role of intertendinous connections in distribution of force in the human extensor digitorum muscle

Role of intertendinous connections in distribution of force in the human extensor digitorum muscle

The prevalence of the extensor indicis tendon and its variants: a systematic review and meta-analysis

The anatomical variations of the extensor tendons to the dorsum of the hand

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