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The Effect of Extensor Tendon Adhesions on Finger Motion.

David J Graham1, Harry D S Clitherow1, Harvinder P Singh1

  • 1Department of Hand Surgery and Peripheral Nerve Surgery, Royal North Shore Hospital, Sydney, Australia.

The Journal of Hand Surgery
|February 9, 2019
PubMed
Summary

Simulated extensor tendon adhesions cause distinct finger motion loss patterns. Adhesions at the proximal phalanx or metacarpal levels restrict movement, with the greatest loss occurring distally to the adhesion site.

Keywords:
Adhesionextensor tendonfingertenolysis

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Area of Science:

  • Orthopedics
  • Hand Surgery
  • Biomechanical Research

Background:

  • Extensor tendon adhesions significantly impair finger range of motion.
  • Understanding the specific patterns of motion loss is crucial for effective treatment.

Purpose of the Study:

  • To quantify finger range of motion loss in metacarpophalangeal (MCP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints.
  • To determine motion loss patterns associated with simulated extensor tendon adhesions at the proximal phalanx or metacarpal levels.

Main Methods:

  • Utilized 10 cadaveric specimens with simulated extensor tendon adhesions.
  • Measured MCP, PIP, and DIP joint angles during simulated active motion with applied weights.
  • Adhesions were simulated at proximal phalanx and metacarpal levels using suture anchors.

Main Results:

  • Proximal phalanx adhesion resulted in average total flexion loss of 38° and extension loss of 6°, with greater flexion loss at the PIP joint.
  • Metacarpal adhesion led to average flexion loss of 17° and extension loss of 50°, primarily affecting the MCP joint's extension.
  • The most significant motion restriction occurred at the joint immediately distal to the simulated adhesion.

Conclusions:

  • Distinct patterns of finger motion loss correlate with the location of simulated extensor tendon adhesions.
  • Predicting adhesion location based on motion restriction patterns may enable targeted tenolysis, potentially reducing repeat adhesion formation.