The flexor tendons flexor digitorum superficialis and flexor digitorum profundus that run along the front of each finger are encased in a continuous sheath of connective tissue. For paralysis of ulnarinnervated flexor digitorum profundus fdp to the ring and small finger, tenodesis of the ulnarinnervated fdp tendons will allow the medianinnervated fdp to drive the function of the ulnarinnervated fdp function. In this article we will discuss about flexor digitorum profundus muscle. Flexor tendon anatomy and injury everything you need to.
Learn about the causes, signs, symptoms, treatment and risk factors of flexor digitorum profundus muscle pain. The flexor digitorum superficialis tendon attaches to the base of the middle phalanx and flexes the pip joint. Some sources alternatively classify this muscle as an independent middleintermediate layer of the anterior forearm, found between the superficial and. Athletes and manual workers are particularly at risk for closed injuries of the flexor system. The flexor digitorum profundus fdp lies deep to the fds and has a dual innervation. The flexor tendons to the digits enter the hand through the carpal tunnel.
Flexor digitorum superficialis washington university in. Feb 05, 2014 unless you carry very heavy shopping bags with one finger, this is 100 percent a climbers injury. Unless you carry very heavy shopping bags with one finger, this is 100 percent a climbers injury. In a complete denervation injury, such as a complete nerve laceration, there will be no evidence of any muscle function and the muscle testing grade will be 0. Flexor digitorum profundus radiology reference article. Fractures of the sustentaculum tali can cause entrapment of the flexor hallucis longus or flexor. This injury occurs most often in athletes involved in contact sports, such as american football or rugby. It is sometimes considered to be the deepest part of the superficial layer of this compartment, and sometimes considered to be a distinct, intermediate layer of this compartment. The injury is often overlooked by players and trainers and misdiagnosed as a jammed or sprained finger, but requires more urgent management than these. The flexor digitorum profundus is a muscle in the forearm of humans that flexes the fingers also known as digits. Flexor digitorum profundus avulsion injuries springerlink.
Jul 30, 2019 the main function of the flexor digitorum profundus muscle is to help in flexion of the fingers. Aug 14, 2019 in this article we will discuss about flexor digitorum profundus muscle. In this report the authors present a case of pure avulsion of the fdp with tendon retraction to the level of pip type ii and concomitant transverse fracture to. During standing the muscle aids with balance by gripping the ground. The fdp tendons are deep to the fds tendons in the forearm, wrist, and hand. Wrist flexor muscles are innervated by the median and ulnar nerves. Flexor digitorum profundus is a flexor of the wrist, metacarpophalangeal and interphalangeal joints. The flexor muscles are located in the forearm directly above the write. They are comprised of the flexor digitorum superficialis fds for each finger, flexor digitorum profundus fdp for each finger, and flexor pollicis longus fpl to the thumb. Flexor tendon injury, repair and rehabilitation orthopedic clinics. The flexor tendons are simply the tissue that connects the muscles to your bone in this area. Flexor digitorum profundus i, ii peripheral nerve surgery. It is the only muscle that can flex the distal interphalangeal joints of the fingers.
A case of a patient with no history of autoimmune disease who suffered a traumatic rupture of the flexor digitorum profundus tendon to the ring finger in the midpalm is reported. Relaxation of the extensors leads to relative flexor shortening, but is not necessarily active finger flexion. The flexor digitorum superficialis fds and flexor digitorum profundus fdp originate proximally in the forearm, at the medial epicondyle of the. These are the tissues that help control movement in your hand. And even better, although it feels sharply debilitating, you can climb as much as you want. Traumatic avulsions of the flexor digitorum profundus tendon are usually presented in young adults engaged in athletic activities like football. The two prime movers of grip force are flexor digitorum superficialis fds and flexor digitorum profundus fdp. Flexor digitorum profundus tenodesis median fdp to ulnar. A patient with jersey finger may present with pain and swelling at the volar. If you experience a deep cut to the palm side of your fingers, hand, wrist, or forearm, you may damage your flexor tendons. Flexor digitorum profundus muscle pain is debilitating and can make one unable to perform activities of daily living. A flexor tendon injury can make it impossible to bend your fingers or thumb. Digitorum meaning in the cambridge english dictionary.
Know the causes, signs, symptoms and treatment for flexor digitorum longus pain. This injury involves mainly young and active patients, especially during sports activities. Mar 24, 2015 the flexor digitorum profundus helps flex the fingers. This flexor tendon can rupture from its attachment to the fingertip when excessive stress is. These tendons, along with those of flexor digitorum profundus, are enclosed by a common flexor sheath. It belongs to the superficial flexors of the forearm, together with pronator teres, flexor carpi radialis, flexor carpi ulnaris and palmaris longus. Flexor tendon injury at the dip joint, jersey finger, flexor digitorum profundus avulsion, fdp tendon injury, dip flexor tendon avulsion. The function of the flexor digitorum longus muscle is to facilitate movement of the foot. Flexor digitorum superficialis is the largest muscle of the anterior compartment of the forearm. Flexor tendon injury of the distal interphalangeal joint jersey finger. Theyre the muscle that move the fingers and the thumb on your hand and help you operate. In muscle testing, an abnormal result is a negative one.
The function of the flexor digitorum superficialis muscle is to help in flexion of four medial fingers of the hand. However, flexor digitorum profundus to the long, ring, and small fingers always have a common muscle belly. The main function of the flexor digitorum profundus muscle is to help in flexion of the fingers. Commonly referred to as a jersey finger because of its association with tackling sports, the distal aspect of fdp is avulsed from its insertion on the distal phalanx in zone i, with or without a fragment of bone. This article describes a novel technique for flexor digitorum profundus fdp avulsion injuries, useful for leddy packer type 3, 4, and 5 injuries. Flexor digitorum superficialis muscle straincauses. Management of flexor tendon injuries in hand intechopen. Thus, the flexor muscle is used to aid the lumbrical muscles in their role as extensors of the interphalangeal joints. Flexor digitorum profundus muscle paincausestreatmentsigns. Rupture of small finger flexor tendons secondary to. A flexor tendon injury occurs within the area of the palm side of the hand or forearm. Flexor digitorum profundus is inserted on volar aspect, near the base, of distal phalanx of the respective finger. The tendons attach to the anterior margins on the bases of the intermediate phalanges of the four fingers. Avulsions of the flexor digitorum profundus tendon may involve tendon retraction into the palm and fractures of the distal phalanx.
During the propulsion phase of walking, running or jumping, flexor digitorum longus pulls the toes downwards towards the ground to attain maximal grip and thrust during toeoff. Note that the injured finger is held in forced extension. Each finger has two flexor tendonsthe flexor digitorum sublimis fds and flexor digitorum profundus fdp. Avulsion fracture of the flexor digitorum profundus tendon jersey finger is an uncommon injury. This flexor tendon can rupture from its attachment to the fingertip when excessive stress is applied to it.
One of the flexor tendonsthe flexor digitorum profundusbends the fingertip. Together the flexor pollicis longus, pronator quadratus, and flexor digitorum profundus form the deep layer of ventral forearm muscles. Flexor tendon reconstruction indications are somewhat controversial, but it is generally accepted as an option when primary repair has failed, when a flexor tendon injury is missed, and for crush injuries, contaminated injuries, open fractures, skin deficiencies, and considerably scarred digits. Licensed to youtube by sme on behalf of spooks music. Palpate the flexor digitorum superficialis tendon at the volar wrist ulnar to the palmaris longus or flexor carpi radialis tendons. Jan 24, 2019 the function of the flexor digitorum longus muscle is to facilitate movement of the foot. The probable mechanism responsible for the injury and the.
Unclassified avulsion injury of the flexor digitorum. Closed ruptures of the flexor digitorum profundus fdp tendon cause a loss of active flexion at the distal interphalangeal joint. Flexor digitorum profundus fdp makes up the third layer of the anterior compartment of the forearm along with flexor pollicis longus. Although various repair techniques have been described, none has emerged as superior to others. The muscle originates in the upper part of the ulna bone. This page includes the following topics and synonyms. Along this sheath, there are five thickened areas that create annular pulleys a1, a2, a3, a4, and a5 as well as three to four cruciform pulleys. Mar 01, 2006 flexor digitorum profundus tendon injury jersey finger. Flexor digitorum profundus tendon injury jersey finger. During an abnormal muscle test, the examiner should observe an abnormal muscle contraction that can move the joint or tendon.
Flexor tendon injury musculoskeletal medicine for medical. Avulsion injuries of the flexor digitorum profundus tendon abstract avulsions of the. Increased attention to injuries acquired during this form of activity is suggested. Flexor digitorum superficialis peripheral nerve surgery. It is considered an extrinsic hand muscle because it acts on the hand while its muscle belly is located in the forearm.
After some research i concluded my injury was the flexor digitorum profundus, seeing as the pain was most severe when applying pressure to the distal phalanges. It inserts at the distal phalanges in the tips of the fingers. Finger flexion that results after relaxation from finger hyperextension. Closed injuries of the fingers cause welldefined flexor injuries. Avulsion injuries of the flexor digitorum profundus tendon. Flexor digitorum profundus avulsion injury jersey finger leddypacker classification zone i flexor tendon injury flexor tendon reconstruction this is. The lumbricals, intrinsic muscles of the hand, attach to the tendon of flexor digitorum profundus. Finger flexor tendon rupture new york, ny handsport. Review article avulsion injuries of the flexor digitorum. The flexor system of the fingers consisting of flexor tendons and finger pulleys is a key anatomic structure for the grasping function. The flexor digitorum superficialis fds and flexor digitorum profundus fdp originate proximally in the forearm, at the medial epicondyle of the elbow. Flexor digitorum profundus avoid by maintaining distal interphalangeal joints in extended position. Which of the following results from a rupture of the flexor digitorum profundus tendon. Closed rupture of flexor digitorum profundus in zone iii.
Jersey finger boutonniere deformity mallet finger gamekeepers thumb. A flexor tendon injury can cause loss of flexion bending of the fingers or thumb. Originates from the ulna and associated interosseous membrane. Note that flexor digitorum profundus to the index can provide independent motion if there is an independent muscle belly. Intratendinous ruptures of a flexor digitorum profundus tendon are rare in patients who do not have rheumatoid arthritis. The flexor digitorum profundus and superficialis to. Rupture of flexor tendons due to nonunion of the hook of the hamate is an uncommon injury. Flexor digitorum longus pain can occur with a trip and fall on uneven surface when the toes are not able to grip the surface totally. May 03, 2012 a flexor tendon injury can cause loss of flexion bending of the fingers or thumb. Know the causes, signs, symptoms, treatment and rsk factors of flexor digitorum superficialis muscle strain.
Traumatic intratendinous flexor digitorum profundus rupture. The most challenging injuries are those in zone ii of the finger where both the flexor digitorum profundus fdp and flexor digitorum superficialis fds are found in close apposition within the confines of the fibroosseous flexor tunnel. They, along with flexor pollicis longus fpl and the median nerve, travel through the carpal tunnel at the wrist and enter the palmar surface of the hand. Flexor digitorum longus painsymptomscausestreatment. Jersey finger also called rugby finger or sweater finger describes a type of injury where there is avulsion of the flexor digitorum profundus fdp at the base of the distal phalanx base volar 1. Traumatic avulsion of the insertion of the tendon of flexor digitorum profundus of 2. At the wrist, it splits into four tendons, that pass through the carpal tunnel. Multidirectional stability is achieved with combination pullout suture, which neutralizes the deforming force of fdp, and cerclage wire, which holds the bone fragment in an anatomic position and provides interfragmentary compression. Traumatic avulsion of the insertion of flexor digitorum. The flexor digitorum profundus helps flex the fingers. Flexor digitorum superficialis flexor digitorum sublimis is an extrinsic flexor muscle of the fingers at the proximal interphalangeal joints it is in the anterior compartment of the forearm. Fixation of a type 3 flexor digitorum avulsion injury. Flexor digitorum profundus muscle paincausestreatment. Most commonly affects the 4 th digit as the fdp insertion into the ring finger is anatomically weaker than the middle finger 2.
624 1647 134 609 1431 396 801 1506 244 1617 483 485 833 405 7 259 1449 801 1281 965 499 1309 1117 396 1084 470 807 85 891 1359 811 953 1139 1437 791 557 973 1321 965 1154