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Related Experiment Videos

Finkelstein's test: a biomechanical analysis.

Keiji Kutsumi1, Peter C Amadio, Chunfeng Zhao

  • 1Biomechanics Laboratory, Division of Orthopedic Research, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN 55905, USA.

The Journal of Hand Surgery
|February 1, 2005
PubMed
Summary
This summary is machine-generated.

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Finkelstein's test for de Quervain's disease shows increased bulk and tethering for the extensor pollicis brevis (EPB) tendon in the tested wrist position. This effect was not observed for the abductor pollicis longus (APL) tendon.

Area of Science:

  • Orthopedics
  • Anatomy
  • Biomechanics

Background:

  • Finkelstein's test is a standard diagnostic for de Quervain's disease.
  • The test's efficacy is linked to the position of the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons within the first extensor compartment.

Purpose of the Study:

  • To investigate Finkelstein's hypothesis regarding tendon positioning in de Quervain's disease.
  • To quantify the "bulk" (muscle mass) and "tethering" (synovial stretching) effects on EPB and APL tendons in the Finkelstein test position.

Main Methods:

  • Utilized 15 fresh-frozen cadavers to measure tendon excursion and gliding resistance.
  • Assessed EPB and APL tendons in four wrist positions, including 30 degrees ulnar deviation (Finkelstein's position).
  • Calculated bulk and tethering effects based on gliding resistance and tendon excursion.

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Main Results:

  • The EPB tendon exhibited significantly greater distal excursion and higher bulk/tethering resistance in 30 degrees ulnar deviation compared to 60 degrees extension.
  • No significant differences in excursion or resistance were found for the APL tendon between these wrist positions.
  • Results indicate the EPB tendon is more affected in the Finkelstein test position.

Conclusions:

  • The Finkelstein test position significantly increases distal excursion and bulk/tethering effects for the EPB tendon.
  • These findings support Finkelstein's hypothesis, suggesting the test primarily reflects EPB tendon changes.
  • The APL tendon does not show similar changes, implying de Quervain's disease presentation may be more related to EPB abnormalities.