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Published on: December 2, 2022
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A Novel Cadaveric Model of the Quadriga Effect.
Andrew Schannen1, Samuel Cohen-Tanugi1, Matthew Konigsberg1
1Department of Orthopaedic Surgery, Columbia University Medical Center, New York, NY.
Summary
Even slight shortening of the flexor digitorum profundus (FDP) tendon can cause the quadriga phenomenon. This condition, affecting adjacent finger mobility, is more severe when the ring or small finger FDP tendons are shortened.
Area of Science:
- Orthopedic surgery
- Hand surgery
- Biomechanics
Background:
- The quadriga phenomenon arises from excessive shortening of the flexor digitorum profundus (FDP) tendon.
- This shortening impacts the functional mobility of the middle, ring, or small finger.
Purpose of the Study:
- To investigate the impact of flexor digitorum profundus (FDP) tendon shortening on adjacent finger mobility.
- To quantify the quadriga phenomenon's severity based on the degree and location of FDP tendon shortening.
Main Methods:
- A cadaveric model was developed to simulate the quadriga phenomenon.
- Flexor digitorum profundus (FDP) tendons of the middle, ring, and small fingers were incrementally shortened by 5 mm.
- Tip-to-palm (TTP) distances of adjacent fingers were measured to assess functional impact.
Main Results:
- A 10 mm shortening of the middle finger FDP tendon caused a 6 mm TTP distance in the ring finger and 5 mm in the small finger.
- Shortening the ring finger FDP tendon by 10 mm resulted in 11 mm TTP in the middle finger and 9 mm in the small finger.
- A 10 mm shortening of the small finger FDP tendon led to a 14 mm TTP in the middle finger and 10 mm in the ring finger.
Conclusions:
- As little as 10 mm of flexor digitorum profundus (FDP) tendon shortening can induce a significant quadriga effect.
- The quadriga phenomenon is more pronounced when the ring and small finger FDP tendons are shortened compared to the middle finger FDP tendon.
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