Excursion of the flexor digitorum profundus tendon: A kinematic study of the human and canine digits

Abstract

The most common problem following primary flexor tendon repair is the failure of the tendon apparatus to glide, secondary to the formation of adhesions. Early motion following tendon repair has been shown to be effective in reducing adhesions between the tendon and the surrounding sheath. Therefore, it is important to determine the amount of flexor tendon excursion along the digit during joint motion. In this study, the excursion between the flexor digitorum profundus (FDP) tendon and the sheath was examined in both human and canine digits. Based on roentgenographic measurements and joint kinematic analysis, the motion of the bones, the FDP tendon, and the sheath were measured with respect to joint rotations. It was found that the canine flexor tendon apparatus behaved similarly to that of the human for the motions studied. The amount of tendon excursion was very small in regions distal to the joint in motion (approximately 0.1 mm/10 degrees of joint rotation). There was little displacement of the sheath (0.2-0.3 mm), except at the metacarpal joint region during metacarpophalangeal (MCP) joint motion and at the proximal interphalangeal (PIP) joint region during PIP joint motion. Tendon excursion relative to the tendon sheath was the largest in zone II during PIP joint rotation (1.7 mm/10 degrees of joint rotation). These results suggest that PIP joint motion may be most effective in reducing adhesions following tendon repair in zone II.

Ultrasonographic Assessment of Long Finger Tendon Excursion in Zone V During Passive and Active Tendon Gliding Exercises

“…McGrouther and Ahmed 7 reported a mean long finger tendon excursion of 17.6 mm during active movement simulated by full extension to 90°PIP joint flexion and 60°DIP joint flexion. Horibe et al 8 reported larger tendon excursions, but these were mean tendon excursions with no distinction between index and long finger FDP tendon excursions. In that study, mean tendon excursion was 30.4 mm during active movement (full extension to 105°MCP joint flexion plus 32°PIP joint flexion plus 15°DIP joint flexion).…”

Prospective Morphologic and Dynamic Assessment of Deep Flexor Tendon Healing in Zone II by High-Frequency Ultrasound: Preliminary Experience

“…It has been observed that DIP joint motion produces excursion of the FDP tendon of 1-2 mm per 10° of joint flexion, whereas each 10° of PIP joint flexion results in excursion of both the FDS and FDP tendons of about 1.5 mm [9,19]. A study by Silfverskiöld et al [20] almost 20 years ago using intratendinous metal markers and postoperative x-ray found a substantial decrease in the movement of tendon repairs compared with normal movement.…”

“…The use of ultrasound imaging in the postoperative course is mainly constrained by the fact that, to our knowledge, there are no data on the sonographic appearance of a sutured tendon in the various phases of the healing process. Furthermore, there is little information available in the literature on the real amount of motion at the suture site [9].…”

Cell and Biologic-Based Treatment of Flexor Tendon Injuries

“…66–69 The canine model for Zone II FDP tendon laceration and repair has been extensively used since 1962. 1,70 Canine flexor tendons are similar to human flexor tendons in both anatomy and function, 61,71 as well as in response to tendon injury, repair, and rehabilitation. 3,24 The canine FDP tendon size is approximately one half the size of a human FDP tendon.…”