Predicting Tendon Tissue Grafting Source From the Extensors of Long Fingers: A Systematic Review of Cadaveric Studies

Abstract

Knowledge of the frequencies of extra slips for each long extensor tendon and extra tendons for each long finger along with their prevalence in different populations would improve: (1) location prevision of tendon source for tendon grafting; and (2) surgical planning while supporting a patient-centered approach. Evidence-based hand anatomy would have a major potential to contribute to the practice of an evidence-based hand surgery. Predicting the possible tendon sources that could be present on the dorsum of the hand is thought to be very valuable for hand surgeons. In addition and from an evolutionary perspective, we hypothesized that the observed significantly higher frequency values of the double-slip and triple-slip types of the EDC of the ring finger, EDC of the little finger, and EDM might indicate a natural selection tendency for a higher independence of the former digits in the future evolution of the human hand.

Extensor Medii Proprius: A Cadaveric Case Report

“…Additionally, information on the anatomical variation in the human hand is important for researchers looking to describe the functional significance and evolution of the human hand [3]. Types of variations previously described in the literature include the extensor digitorum brevis manus (EDBM) [4], the extensor medii proprius (EMP), the extensor indicis et medii communis (EIMC), the extensor pollicis et indicis accessorius (EPI) [2], and variations in the number of extensor digitorum communis (EDC) tendons, slips and their insertion sites [5]. The EDBM is defined as originating from the distal end of the radius and radiocarpal ligaments and inserting into the metacarpophalangeal joint of the third digit [4].…”

“…Forearm extensor anomalies are relatively common [ 1 ]. Identification, recognition, and description of such anomalies are important to add to the existing literature, as they can provide information to medical practitioners on the anatomical variation in the hands for various types of hand surgeries [ 2 ]. Additionally, information on the anatomical variation in the human hand is important for researchers looking to describe the functional significance and evolution of the human hand [ 3 ].…”

“…The EMP can be used in tendon reconstruction to restore abduction of the thumb or extension in the fingers. The second and fifth digits are more likely sources of extra slips/tendons for tendon transfer in surgery as they are more frequently present compared to the EMP [ 2 ]. A meta-analytic review of 22 studies with a combined sample size of 3,984 extremities reported the true prevalence of the EMP tendon as 3.7% with higher rates in Japanese and North American populations compared to European and Indian populations [ 10 ].…”