A Novel Adhesion Index for Verifying the Extent of Adhesion for the Extensor Digitorum Communis in Patients with Metacarpal Fractures

Abstract

This study aims to determine if the relative displacement between the extensor digitorum communis (EDC) tendon and its surrounding tissues can be used as an adhesion index (AI) for assessing adhesion in metacarpal fractures by comparing two clinical measures, namely single-digit-force and extensor lag (i.e., the difference between passive extension and full active extension). The Fisher–Tippett block-matching method and a Kalman-filter algorithm were used to determine the relative displacements in 39 healthy subjects and 8 patients with metacarpal fractures. A goniometer was used to measure the extensor lag, and a force sensor was used to measure the single-digit-force. Measurements were obtained twice for each patient to evaluate the performance of the AI in assessing the progress of rehabilitation. The Pearson correlation coefficient was calculated to quantify the various correlations between the AI, extensor lag, and single-digit-force. The results showed strong correlations between the AI and the extensor lag, the AI and the single-digit-force, and the extensor lag and the single-digit-force (r = 0.718, −0.849, and −0.741; P = 0.002, P < 0.001, and P = 0.001, respectively). The AI in the patients gradually decreased after continuous rehabilitation, but remained higher than that of healthy participants.

Palmar approach for fixation of metacarpal fractures

“…Considering the proximity of the skin to the bone and the subcutaneous tissues on the dorsum of the hand, complications of the dorsal approach, such as limitation of ROM due to the adhesion of extensor tendons to the scar, can be bothersome (Lai et al., 2016). In addition, extensor tendons can adhere to the bony callus (Chinchalkar and Pipicelli, 2009).…”