Type 5 Avulsion of the Insertion of the Flexor Digitorum Profundus Tendon

Al-Qattan, M. M.

doi:10.1054/jhsb.2001.0619

Cited by 57 publications

(33 citation statements)

References 12 publications

(11 reference statements)

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“…Additions to the Leddy and Packer classification were made because there were FDP injuries seen that did not fit perfectly into one of the original three types. Properly classifying them is important to the hand surgeon because it helps to determine treatment of the patient and timing of surgery [1]. In Type I avulsions, which are the most rare, the tendon retracts proximal to the A1 pulley.…”

Section: Discussionmentioning

confidence: 99%

“…Both vincula remain intact in this injury. Type IV injuries also involve avulsion of a large bony fragment; however, they differ from Type III injuries in that the tendon is pulled away from the fragment and lies at the level of the PIP joint or palm [1]. Type IV injuries should be treated within 7 to 10 days [1].…”

Section: Discussionmentioning

confidence: 99%

“…Type IV injuries also involve avulsion of a large bony fragment; however, they differ from Type III injuries in that the tendon is pulled away from the fragment and lies at the level of the PIP joint or palm [1]. Type IV injuries should be treated within 7 to 10 days [1]. Finally, Type V injuries denote those in which an osseous fragment with attached tendon is pulled away from the distal phalanx and there is a substantial extension of the fracture into the distal phalanx.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, Type V injuries denote those in which an osseous fragment with attached tendon is pulled away from the distal phalanx and there is a substantial extension of the fracture into the distal phalanx. Type V injuries are subdivided into Types Va and Vb based on whether the distal phalanx fracture is intraarticular versus extraarticular, respectively [1]. Ideally, these injuries should be treated within 2 weeks, especially if intraarticular or displaced [1].…”

Section: Discussionmentioning

confidence: 99%

“…Type V injuries are subdivided into Types Va and Vb based on whether the distal phalanx fracture is intraarticular versus extraarticular, respectively [1]. Ideally, these injuries should be treated within 2 weeks, especially if intraarticular or displaced [1].…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Pseudotendon Formation after a Type III Flexor Digitorum Profundus Avulsion

Pappas

Major

Bozentka

2011

Clinical Orthopaedics &Amp; Related Research

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Background Avulsion of the flexor digitorum profundus tendon is a common injury to the hand that virtually always requires surgical repair for restoration of normal finger function. Case Description We report a case of a Type III flexor digitorum profundus tendon avulsion in which the patient refused surgery yet attained nearly full active ROM and an excellent functional result via the formation of a pseudotendon, as observed on MRI obtained 2.5 years after the initial injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Case Report: Pseudotendon Formation after a Type III Flexor Digitorum Profundus Avulsion

Pappas

Major

Bozentka

2011

Clinical Orthopaedics &Amp; Related Research

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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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Ultrasound of flexor digitorum apparatus in acute and chronic pathology

Sirlyn¹,

Bird²

2018

Sonography

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The flexor digitorum apparatus (FDA) of the finger consists of two flexor tendons located within their osteofibrous tunnel, reinforced by the pulley apparatus and the supporting volar plates. The FDA is essential for facilitating hand grasping functions, and pathology affecting the FDA can result in functional impairment of the hand. These injuries can be open or closed in nature and are commonly the sequelae of acute trauma or chronic overuse. This article includes an overview of the anatomy of the FDA, ultrasound scanning technique and common pathologies that sonographic assessment may encounter. The anatomy of the finger and its variants is complex, and an ultrasound can only be accurate if the operator possesses comprehensive knowledge of these structures.Funding: None. Conflict of interest: None.Sonography 5 104-114

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Type 5 Avulsion of the Insertion of the Flexor Digitorum Profundus Tendon

Cited by 57 publications

References 12 publications

Case Report: Pseudotendon Formation after a Type III Flexor Digitorum Profundus Avulsion

Case Report: Pseudotendon Formation after a Type III Flexor Digitorum Profundus Avulsion

Flexor tendon injuries

Ultrasound of flexor digitorum apparatus in acute and chronic pathology

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